FIG. 32:  Moving on to pulmonary rehabilitation and survival, which is of critical importance for patients with advanced disease, this Figure shows the principal result of the only study of pulmonary rehabilitation given to stable outpatients with COPD and its effect on patient survival.^[21]  This study assessed pulmonary rehabilitation with exercise and education versus education alone and found no difference in effect on survival (Figure).  However, there were only 119 patients in this study, and the design of a study looking at survival with a drug needs to recruit thousands of patients; so study was woefully underpowered, and in any case it did not show even a trend toward improvement in survival.