In some patients with chronic heart failure (CHF) and COPD, physical deconditioning may be so severe that exercise training cannot be initiated. This situation has encouraged the investigation of “local muscle training” by neuromuscular electrical stimulation (NMES) of the lower limbs. In this issue of CHEST (see page 44), Sillen et al1 summarize the best available evidence from the English-language literature to demonstrate the potential of NMES training vs no training or sham stimulation to improve muscle function and quality of life in patients with CHF and COPD. We are aware of at least one other randomized trial2 published in a “foreign” language that suggested similar improvements in walking distance and muscle strength after training in both NMES and voluntary contractions among patients with COPD and respiratory failure. Sillen et al1 did not proceed with a metaanalysis of the available data, arguing that heterogeneity existed across trials. We would certainly agree with this decision that does not diminish the interest of this systematic review.