Impact of Exercise Guidance Timing on Physical and Cognitive Function in Older Adults: A Pilot Study

Round 1

Reviewer 1 Report

please kindly consider the given points and revise them:

Title: I recommend to include the suggested one instead of yours: Impact of Exercise Guidance Timing on Physical and Cognitive Function in Older Adults: A Pilot Study"

Abstract:

*The abstract does not mention how the sample size was determined, which may raise questions about the statistical power of the study.

*While the study was single-blinded, it is not clear who was blinded (participants or assessors) and whether this could have influenced the results.

Introduction: 

*While the introduction provides a good background on the OEP and its potential benefits, it is not clear what the specific research question of the study is. The introduction should clearly state the purpose of the study and the specific research question(s) that the study aims to answer.

*The literature review in the introduction is relatively brief and does not provide a comprehensive overview of the existing research. A more detailed review of the literature, including a discussion of the strengths and limitations of previous studies, would help to provide a more solid foundation for the study. you can use the following references:

10.4103/iahs.iahs_23_19

10.32598/sija.13.3.312

Methode:

*Small sample size: The study involved only two equal groups with an unspecified number of participants in each group. Small sample sizes can limit the generalizability of the findings and decrease the statistical power of the study.

*Single-blinded design: While the study was single-blinded, meaning that the participants did not know which group they belonged to, it would have been preferable to have a double-blinded design in which neither the participants nor the leaders knew which group they were in. This would have reduced the potential for bias in the study.

*Lack of control group: The study did not include a control group, which would have allowed for a comparison of the effects of the OEP with the effects of not receiving any intervention. This would have provided a more robust evaluation of the effectiveness of the OEP.

*Lack of detail on delivery of guidance: The study provided limited information on the specific delivery of visual and verbal guidance in the two groups. Without more detail on the delivery of guidance, it is difficult to assess the validity of the study's findings.

*The study only had a 12-week follow-up period, which may not be sufficient to determine the long-term effects of exercise guidance timing on the assessed variables.

Although exercise adherence was documented, the abstract does not provide information on the adherence rates for each group, which could be important in interpreting the results.

 

Results: well written

 

Discussion and Conclusion:

Overall, the discussion section of this study is well-written and provides a clear and concise summary of the study's findings. However, there are a few potential areas for improvement.

*Firstly, the discussion could benefit from a more detailed explanation of the limitations of the study. While the authors do mention some limitations, such as the small sample size and lack of a control group, they do not explore these limitations in depth or discuss their potential impact on the study's findings.

Secondly, while the authors suggest that the advance guidance group may have performed better on cognitive tests due to the feedback provided during exercise, they do not provide any evidence to support this claim. It would be helpful if the authors could cite relevant research or provide a more detailed explanation of why they believe feedback during exercise would improve cognitive function.

Finally, while the authors suggest that the Otago program is effective at reducing falls, they do not explore the potential limitations of this program or discuss how it compares to other fall prevention interventions. A more detailed discussion of the effectiveness of the Otago program and its limitations would provide readers with a more complete understanding of the study's findings.

Overall, the discussion and conclusion provide a comprehensive summary of the study's findings and their implications. The authors offer a plausible explanation for the observed improvements and provide valuable insights into the potential benefits of the OEP program in improving physical performance in the elderly.However, one potential limitation of this study is that it only compared two groups, the advance guidance group and the parallel guidance group. It would have been interesting to include a third group that received no guidance, to evaluate the effect of guidance on the outcomes measured. Additionally, the study did not include a long-term follow-up to evaluate the sustainability of the improvements observed.

 

 

Author Response

Thank you for your comments. Please see the attached cover letter of our reply

Sofia Lampropoulou

Author Response File: Author Response.docx

Reviewer 2 Report

The paper presents a study that evaluates the effects of guidance delivery time on balance, gait, falls, and cognitive functions. The subject seems exciting and topical, considering that falls affect the older population and are a growing problem worldwide.

The paper is generally well structured, and the abstract sufficiently reflects the content.

The introduction presents the purpose of the investigation, and the goal is supported by the pertinent literature. However, I also recommend the following works:

1.      Janatová, M.; Pětioký, J.; Hoidekrová, K.; Veselý, T.; Hána, K.; Smrčka, P.; Štěpánek, L.; Lippert-Grünerová, M.; Jeřábek, J. System for Game-like Therapy in Balance Issues Using Audiovisual Feedback and Force Platform. Electronics 2022, 11, 1179. https://doi.org/10.3390/electronics11081179

2.      Veselý, T.; Janatová, M.; Smrčka, P.; Vítězník, M.; Kliment, R.; Hána, K. Measuring of the Energy Expenditure during Balance Training Using Wearable Electronics. Electronics 2022, 11, 1096. https://doi.org/10.3390/electronics11071096

3.      Rebelo, F.L.; Silva, L.F.D.; Dona, F.; Barreto, A.S.; Quintans, J.D.S. Immersive virtual reality is effective in the rehabilitation of older adults with balance disorders: A randomized clinical trial. Exp Gerontol 2021, 149, doi:10.1016/j.exger.2021.111308.

4.      Ciorap, R.; Andriţoi, D.; Casuţă, A.; Ciorap M.; Munteanu, D. Game-based virtual reality solution for post-stroke balance rehabilitation. IOP Conference Series: Materials Science and Engineering, vol. 1254, no. 1, 2022, pp. 012037. DOI: 10.1088/1757-899x/1254/1/012037

5.      Lee, K. Virtual Reality Gait Training to Promote Balance and Gait Among Older People: A Randomized Clinical Trial. Geriatrics-Basel 2021, 6, doi:10.3390/geriatrics6010001.

The study methods are appropriate, and the data are valid.

The results are highlighted, and the conclusions are adequate.

Minor comments:

 

-fig 1 needs to be redone because the text is not well framed in the rectangles

Author Response

Dear Reviewer, thank you for your review and your comments. Please se attached file with our reply

Sofia Lampropoulou

Corresponding Author

Author Response File: Author Response.docx

Reviewer 3 Report

The Effect of exercise guidance time delivery on balance, gait, falls, cognitive function, and adherence of older adults. A pilot Study compared two approaches: providing exercise guidance ahead of the program versus delivering guidance during the program. The key findings seem to suggest that more people were able to adhere to the exercise program when given guidance ahead of time. Additionally, among those who followed the training plan, there was no significant difference in the improvement observed, regardless of whether they received guidance ahead of time or during the program.

Individual learning patterns and preferences may play a role in these results is valid. People indeed have different learning styles and preferences, which could influence how they engage with exercise guidance. Some individuals may prefer to receive instructions before starting the program, allowing them to familiarize themselves with the routine and plan their activities. Others might find it more effective to have guidance accessible during the exercise session, enabling them to refer to instructions as needed. By acknowledging these potential differences in learning patterns and preferences, the authors could refine their study design to better capture and understand these nuances.

You can also give the guidance both ahead of and during the exercise program. 

 

Language is OK.

Author Response

Please se the attachment

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Its been sufficiently improved for publication.