To improve physical function, a training frequency per week of 3–5 is recommended for ET.26 However, scheduled training twice a week may be considered an upper limit of the attainable over time in this traditionally sedentary group of individuals, and is also a common training frequency offered COPD patients by PR programs.27, 28 Some previous studies of aerobic exercise training less than three times weekly for COPD patients have shown improved exercise capacity,20, 21,27 whereas others have not.29 In our ET group, did not increase, but WRpeak, TET and triceps surae strength improved and there were no signs of a decline in endurance. Although biceps strength tended to decline, the ADL-test, which includes multiple lifting of weights, showed a positive development. Consequently, ET at the chosen level was adequate to at least maintain the improvement in physiological functions gained during IPR. Also, a similar level of physical activity has been associated with a reduced risk of hospitalisation and respiratory death of at least 30% in a population based cohort study.30