Impaired arm activity in COPD: a questionable goal for rehabilitation.

The most common extrapulmonary problems in chronic obstructive pulmonary disease (COPD) patients are cardiovascular comorbidities, muscle weakness and dysfunction [1–3]. Indeed, the reduced peripheral muscle mass and strength increase patient’s symptoms during effort (fatigue and or dyspnoea) and progressively lead to disability. Furthermore, both lower and upper limb dysfunction has been shown to independently predict the long-term prognosis of COPD patients [2].