Meys R, Sillen MJ, Franssen FME, et al. - By performing this retrospective analysis, researchers focused on the influence of mild-to-moderate acute exacerbations of chronic obstructive pulmonary disease (AECOPD) on adherence/results of a high-frequency (HF) or low-frequency (LF) neuromuscular electrical stimulation (NMES) training program, as component of inpatient pulmonary rehabilitation (PR), among people suffering from COPD who were severely dyspneic and weak. They examined patients (n = 62) who engaged in an 8-week PR program and received NMES as the sole supervised muscle training modality during the program (HF-NMES: n = 33; LF-NMES: n = 29). Exacerbators were those (48.4%) who encountered ≥ 1 AECOPD during PR. In terms of median change in 6-min walking distance, cycle endurance time, and isokinetic quadriceps strength and endurance, no difference was evident between the exacerbation and non-exacerbation group. Findings revealed that among patients with severe COPD who engaged in a PR program which was mainly focused on NMES, there was no influence of the occurrence of mild-to-moderate AECOPD during the program on adherence, intensity, and clinical results in these patients. To potentially counteract exacerbation-associated lower-limb muscle dysfunction and better results of PR, continuing NMES appeared a feasible approach, with HF-NMES being the preferential muscle training modality.