Quadriceps muscle weakness is an important component of COPD. We hypothesised that quadriceps weakness would also be a feature of restrictive lung disease due to scoliosis.We studied 10 patients with severe scoliosis (median (interquartile range, IQR) FEV1 35.3 (11) % predicted), 10 patients with severe, COPD (median (IQR) FEV1 26.5 (9.0) % predicted) and 10 healthy age matched adults. We measured quadriceps strength, exercise capacity and analysed quadriceps muscle biopsies for myosin heavy chain (MyHC) isoform expression and the presence of oxidative stress.Both groups exhibited quadriceps weakness with median (IQR) maximal voluntary contraction force being 46.0 (17.0) kg, 21.5 (21.0) kg and 31.5 (11.0) kg, respectively (p=0.02 and 0.04 respectively for each patient group against controls). Oxidative stress was significantly greater in the quadriceps of both restrictive and COPD patients. The scoliosis patients exhibited a decrease in the proportion of MyHC Type I compared with controls; median (IQR) 35.3 (18.5)% compared with 47.7 (9.3)%, p=0.028. The scoliosis patients also showed an increase in MyHC IIx (median (IQR) 26.3 (15.5)% compared with 11.3 (13.0)%, p=0.01.Quadriceps weakness is a feature of severe scoliosis; the similarities between patients with scoliosis and patients with COPD suggest a common aetiology to quadriceps weakness in both conditions.