**5.1 Response to pulmonary rehabilitation (PR)**

As previously mentioned, in patients with chronic respiratory airway disease, sarcopenia is one of the major problems of these patients, which gradually causes atrophy and weakness in their muscles, ultimately reducing physical activity and severely affecting their quality of life. If they do not participate in pulmonary rehabilitation and physical exercise, they will experience general weakness and a gradual increase in mortality. Therefore, it can be said that the major part of sarcopenia is due to musculoskeletal disorders, which include their structure and physical movement, and should be a top priority in these patients' pulmonary rehabilitation programs. In this study, we aimed to investigate sarcopenia factors in chronic respiratory patients that revealed a significant increase in ultrasound on the rectus femoris cross-sectional area (RFMTCSA) and rectus femoris peripheral as well as on DEXA scans on femoral bone mineral density (FBMD) at the Z-score, in fact, rectus femoris muscle peripheral and femur bone density were among the factors that had positive effects on factors such as leg muscle strength, quality of life, lung function and exercise capacity. Regular rehabilitation programs have shown that they have progressed gradually, but their sarcopenia has dropped significantly, requiring regular, long-term pulmonary rehabilitation.

**Abbreviations**

ATS American Thorax Society AT acid lactic threshold BMI body mass index

*DOI: http://dx.doi.org/10.5772/intechopen.91333*

EI echo intensity

GH general health

kg kilogram L liter

MH mental health O2 oxygen

RP role physical RE role-emotional

SF social functioning

SAP intranet PSSJD US ultrasound VO2 oxygen uptake VE ventilation

**45**

BIA bioelectrical impedance analysis

capacity index CRDs chronic respiratory disease

EMT expiratory muscle training FBMD femur bone mineral density

HRQL health-related quality of life ILT incremental load test IMT inspiratory muscle training

MRC Medical Research Council MVV maximal voluntary ventilation

PR pulmonary rehabilitation PSSJD Parc Sanitari Sant Joan de Deu

PF physical functioning PI value protease inhibitor value pre-RHB pre-rehabilitation post-RHB post-rehabilitation PTH parathyroid hormone

FVC forced vital capacity

COPD chronic obstructive pulmonary disease DEXA dual-energy X-ray absorptiometry ERS European Respiratory Society

FEV1 forced expiratory volume per 1 second

forced vital capacity (FVC)

GOLD global initiative for chronic obstructive lung disease

RFMTCSA Rectus Femoris Mid-Tight Cross Sectional Area

RFcsa rectus femoris cross sectional area

SpO2 peripheral capillary oxygen saturation

SPSS statistical package for the social sciences

RMT respiratory muscle training SMI skeletal muscle index 6MWT 6-minute walking test

BODE Index body mass index, airflow obstruction, dyspnea and exercise

*The Main Clinical Indicators of Sarcopenia in Patients with Chronic Respiratory Disease…*

EWGSOP European Working Group on Sarcopenia in the Elderly

FEV1/FVC expire in the first second of forced expiration (FEV1) to the full,
