Other groups have also tried to reduce the PR frequency of weekly exercise component. These studies are relevant to our research, as we could offer only 1 weekly session of supervised exercise, in contrast to current recommendations. 1,3 Thus, Singh et al 9 compared twice-daily home-based walking recorded in a log and monitored once-weekly over 4 weeks with usual activities and found a significant increase in 6MWD for the intervention group but not the control group (54.2±26.7 m versus 6.7±10.3 m, P,0.001). Finnerty et al 8 compared education, plus once-weekly supervised exercise, plus an unsupervised home exercise program of 5 days per week over 6 weeks with usual care and reported a median increase in 6MWD of 51 m (range 20–81 m) in the intervention group. These studies contrast with the limited earlier evidence 7,47 on which the recommendation of at least twice-weekly supervised exercise sessions is based. Further-more, no significant difference between once weekly or twice weekly exercisers for the incremental shuttle walking test was demonstrated in a recent randomized controlled trial. 11 Others included a structured home exercise program to supervised exercise, also finding no additional benefit of two supervised sessions to the incremental shuttle walking test distance. 10 These later studies of weekly versus twice-weekly supervised exercise point to uncertainty over the optimal frequency and mode of supervision required to increase physical capacity. They suggest that once-weekly exercise supervision with a structured home exercise program may be as good as more intensive regimes. To an extent, that is what we have tested, with negative results.