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Functional impairment and skeletal muscle dysfunction can increase the risk of hospitalization and readmission, independent of lung function. In addition, once a patient is admitted, multiple factors can lead to worsening outcome including immobility, systemic inflammation and nutritional depletion. These non\u2010pulmonary factors are potentially amenable to exercise therapy, as part of pulmonary rehabilitation (PR). Peri\u2010exacerbation PR has an important role in the management of exacerbations of COPD. In this review, we explore how functional limitation and skeletal muscle dysfunction affect patients having a severe exacerbation of COPD, the systemic impact of hospitalization on patients including potential aetiologies and the role of PR around the time of an exacerbation. This includes rehabilitation during the inpatient phase, post\u2010exacerbation rehabilitation and rehabilitation bridging hospital discharge. We also describe potential future developments in peri\u2010exacerbation PR.<\/jats:p>","DOI":"10.1111\/resp.13516","type":"journal-article","created":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T15:19:57Z","timestamp":1551799197000},"page":"889-898","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Rehabilitation in chronic respiratory diseases: In\u2010hospital and post\u2010exacerbation pulmonary rehabilitation"],"prefix":"10.1111","volume":"24","author":[{"given":"Wadah","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Department of Respiratory Sciences University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa C.","family":"Harvey\u2010Dunstan","sequence":"additional","affiliation":[{"name":"Division of Physiotherapy and Rehabilitation Sciences, School of Health Sciences University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0453-7529","authenticated-orcid":false,"given":"Neil J.","family":"Greening","sequence":"additional","affiliation":[{"name":"Department of Respiratory Sciences University of Leicester  Leicester UK"},{"name":"Centre for Exercise and Rehabilitation Science Institute for Lung Health  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,5]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organisation. 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