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I have read the paper by McDowell et al with great interest. While the trial showed no significant improvement in the main outcome measure it is crucial to understand why. The intervention group had 30 patients who were recruited from 6 hospitals over a period of 3 years or in other words hospitals recruited 1-2 patients per year who had personalised (lonely) exercise sessions. Outcomes from rehabilitation of COPD are thought to be driven by a multi-disciplinary approach  and peer-support from fellow patients . The latter is likely to improve resilience  and impact on overall self-reported quality of life.
 Griffiths TL, Burr ML, Campbell IA, Lewis-Jenkins V, Mullins J, Shiels K, Turner-Lawlor PJ, Payne N, Newcombe RG, Ionescu AA, Thomas J, Tunbridge J. Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial. Lancet. 2000 Jan 29;355(9201):362-8.
 Poureslami I, Camp P, Shum J, Afshar R, Tang T, FitzGerald JM. Using Exploratory Focus Groups to Inform the Development of a Peer-Supported Pulmonary Rehabilitation Program: DIRECTIONS FOR FURTHER RESEARCH. J Cardiopulm Rehabil Prev. 2017 Jan;37(1):57-64.
 Bradley-Roberts EM, Subbe CP. Role of Psychological Resilience on Health-Outcomes in Hospitalized Patients with Acute Illness: A Scoping Review. Acute Med. 2017;16(1):10-15.