Aims : Access educational materials here To describe the clinical importance of chronic obstructive pulmonary disease (COPD) muscle dysfunction, the risk factors, and the underlying mechanisms; to discuss the potential relationships and differences between exercise capacity and physical activity in COPD patients; to describe to what extent pulmonary rehabilitation and nutritional support may benefit patients with advanced COPD and severe comorbidities such as poor muscle function and muscle loss; to explore the mechanisms that underlie the impairment of skeletal muscle function and mass loss during acute exacerbations in COPD patients; and to describe the available strategies for treating acute exacerbation-induced muscle dysfunction and loss.