Discussion
Summary of results
This is the first study to investigate the effect of the
CDSMP itself on physical capacity in COPD, and whether
limited supervised exercise produces additional benefit.
This is important, because current formats of PR with an
emphasis on lecture-style education and multiple weekly,
health professional-supervised exercise sessions is costly,
reaches only up to 50% of those to whom it is offered,3 and
has waning effects over time.3 Wider-reaching, more cost-
effective and sustainable alternatives are needed.
We found a statistically significant mean increase in
6MWD for both groups, but no extra benefit for the super-
vised exercise component, apart from some evidence for
an increase in the mean duration of moderate self-reported
exercise by 1 hour in the intervention group. However, this
probably reflected just what participants had received in
the intervention itself. There was also an increase in “role
physical” of the SF-36 for both groups, although this lost sta-
tistical significance following the Bonferroni adjustment.