Conclusion
In conclusion, participants with COPD attending a CDSMP can expect a small increase in their physical capacity, but there seems little point in adding a single supervised exercise session. Either there needs to be a more intensive conventional exercise program as advocated in guidelines, or new ways need to be investigated for successfully fostering adequate amounts of home or community-based exercise which meet current recommendations for optimizing health benefits. Before completely abandoning the CDSMP plus limited supervised exercise approach, we are currently undertaking such a trial using an additional community-based mentoring component.