A Review of the Plantar Pressure Distribution Effects from Insole Materials and at Different Walking Speeds

Round 1

Reviewer 1 Report

There are some comments and suggestions to improve the work as following. Also, please see the attached file.

1. Some abbreviations need to state the full words.
2. In the Materials and Methods section, why was the starting year of each database not the same?
3. Figure 1, I would suggest to make it consistency with above as "Full paper excludes".
4. In Table 1, please use small letter for the beginning of words.
5. In Table 1, I do not agree to make mean values because the studies might be different in the setup.
6. In Figure 3, is this a mean value?
7. Figure 4, it will be better if the authors make this figure in color plot.
8. Table 5, I do not agree to make mean values because the studies might be different in the setup.
9. Figure 5, I would suggest to use "Infill density"
10. Line 311, I wonder that this is the intention of the authors or not. Why did the authors say "that improve PPP" instead of "that reduce PPP"? Or it might be "that improve PPP reduction" Or "that affect PPP".

Author Response

We appreciate your valuable time in reviewing our work for Applied Sciences. Our article gets more easily understandable with recent comments and suggestions. We made the following responses and supplement data; all changes have been indicated in the revised manuscript using the track changes function. The detailed point-by-point responses are listed below.

 

Q1. The abbreviations

## Reviewer's Response:

Some abbreviations need to state the full words.

## Authors' Response:

We concur that an abbreviation is a shorter version of a word or phrase that aids the reader in comprehending the message contained in our article. Furthermore, we agree that the abbreviations need to state the full words at the first time in the [1] abstract, [2] content (introduction to conclusion, [3] each figure and table to make the readers easily understand.

We have revised and added the revised manuscript as shown at:

Content

*** Page: 2, line 81

The Ethylene-vinyl acetate (EVA), Poron, …

Figure or table

*** Page: 5, line 147-148

Figure 2. Published paper for reduction peak plantar pressure strategies. DM, diabetes mellitus; non-DM, healthy people; EVA, Ethylene-vinyl acetate.

*** Page: 7, line 178-180

Figure 3. The PPP at three regions (A) forefoot, (B) midfoot, and (C) rearfoot. The speed was categorized as preferred walking speed in people with DM (4 km/h) and five different speeds in non-DM people (4, 6, 8, 10, and 12 km/h, respectively). PPP, peak plantar pressure; DM, diabetes mellitus; non-DM, healthy people.

*** Page: 13, line 229-230

Note: DM, diabetes mellitus; PPP, peak plantar pressure; MTH, metatarsal head; EVA, Ethylene-vinyl acetate; PPT, professional protective technology; PU, Polyurethane; n/a, not applicable.

*** Page: 13, line 231-232

Figure 5. Pressure reduction in different insole material properties (A) PU foam, (B) 3D printed thermoplastic PU and (C) EVA. PU, Polyurethane; EVA, Ethylene-vinyl acetate; 3D, three dimensions.

 

Q2. The starting year of each database

## Reviewer's Response:

In the Materials and Methods section, why was the starting year of each database not the same?

## Authors' Response:

We wrote the different starting points as provided by each database, but the same year searched for studies (April 2021). The sentence has been modified as follows:

*** Page: 3, line 107-109

We searched for published articles through four databases in April 2021, ProQuest (1983 to 2021), PubMed (1976 to 2021), ScienceDirect (1998 to 2021), and Web of Science (1977 to 2021).

 

Q3. Figure 1, full paper excluded

## Reviewer's Response:

Figure 1, I would suggest to make it consistency with above as "Full paper excludes".

## Authors' Response:

The figure had been modified as follows.

 

Q4. Small letter

## Reviewer's Response:

In Table 1, please use small letter for the beginning of words.

## Authors' Response:

The researchers had been modified the PPP into peak plantar pressure

*** Page: 6, line 173

Table 1. The peak plantar pressure in preferred walking speed in people with DM and different walking speed in non-DM people

 

Q5. Mean values

## Reviewer's Response:

In Table 1, I do not agree to make mean values because the studies might be different in the setup.

## Authors' Response:

Our decision to average the pressure reduction is owing to the previously published journal providing average values in the chart/diagram (Franz, VanWormer et al. 2007, Geneva, Cuzzo et al. 2019).

 

## Franz, M. J., J. J. VanWormer, A. L. Crain, J. L. Boucher, T. Histon, W. Caplan, J. D. Bowman and N. P. Pronk (2007). "Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up." Journal of the American Dietetic association 107(10): 1755-1767.

## Geneva, I. I., B. Cuzzo, T. Fazili and W. Javaid (2019). Normal body temperature: a systematic review. Open forum infectious diseases, Oxford University Press US.

 

Q6. Figure 3

## Reviewer's Response:

In Figure 3, is this a mean value?

## Authors' Response:

Yes, our decision to average the pressure reduction is owing to the previously published journal providing average values in the chart/diagram (Franz, VanWormer et al. 2007, Geneva, Cuzzo et al. 2019).

 

## Franz, M. J., J. J. VanWormer, A. L. Crain, J. L. Boucher, T. Histon, W. Caplan, J. D. Bowman and N. P. Pronk (2007). "Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up." Journal of the American Dietetic association 107(10): 1755-1767.

## Geneva, I. I., B. Cuzzo, T. Fazili and W. Javaid (2019). Normal body temperature: a systematic review. Open forum infectious diseases, Oxford University Press US.

 

 

Q7. Figure 4

## Reviewer's Response:

Figure 4, it will be better if the authors make this figure in color plot.

## Authors' Response:

The figure had been modified as follows.

 

Q8. Table 5

## Reviewer's Response:

Table 5, I do not agree to make mean values because the studies might be different in the setup

## Authors' Response:

Our decision to average the pressure reduction is owing to the previously published journal providing average values in the chart/diagram (Franz, VanWormer et al. 2007, Geneva, Cuzzo et al. 2019).

 

## Franz, M. J., J. J. VanWormer, A. L. Crain, J. L. Boucher, T. Histon, W. Caplan, J. D. Bowman and N. P. Pronk (2007). "Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up." Journal of the American Dietetic association 107(10): 1755-1767.

## Geneva, I. I., B. Cuzzo, T. Fazili and W. Javaid (2019). Normal body temperature: a systematic review. Open forum infectious diseases, Oxford University Press US.

 

 

Q9. Figure 5

## Reviewer's Response:

Figure 5, I would suggest to use "Infill density"

## Authors' Response:

The figure 5 had been modified as follows. We also revise the content as your suggestion:

*** Page: 15, line 290-291

The mechanical properties of the PU insole reduced the pressure by around 30% at 14 Shore A and about 40% in 10 – 16% 3D printing infill density.

 

Q10. improve PPP reduction

## Reviewer's Response:

I wonder that this is the intention of the authors or not. Why did the authors say "that improve PPP" instead of "that reduce PPP"? Or it might be "that improve PPP reduction" Or "that affect PPP".

## Authors' Response:

The sentence had been modified as follows.

*** Page: 15, line 313-315

This study is essential in better understanding the insole materials that improve PPP reduction in various walking speeds in people with DM.

Reviewer 2 Report

Table 6. Insole materials function used in plantar regions -We recommend ordering the materials in the table based on their nature ( EVA, PU, etc) and by their characteristics (shore, thickness...)

Author Response

Thank you for your nice comments on our article. We have changed table 6 in our previous draft according to your suggestions. We believe that the revised table would be simpler to be read and understand by the readers. The detailed point-by-point responses are listed below.

 

## Reviewer's Comment:

Table 6. Insole materials function used in plantar regions -We recommend ordering the materials in the table based on their nature (EVA, PU, etc) and by their characteristics (shore, thickness...)

## Authors' Response:

The table has been modified based on their Material Form, Combination material, and Character. Table 6 has been revised as follow attached.

Author Response File: Author Response.pdf

Reviewer 3 Report

Accept in present form

Author Response

We appreciate your valuable time in reviewing our work for Applied Sciences.