Acute Effects of Wild Ginseng Extract on Exercise Performance, Cognitive Function, and Fatigue Recovery: A Randomized Cross-Over, Placebo-Controlled, and Double-Blind Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Corresponding Author, thank you for submiting your work to IJTM and congratulations on your research.

Brief Summary
Your study has examined the acute effects of Wild Ginseng extract (WG) on physical performance, cognitive function and fatique recovery. Using a randomized, double-blind, placebo-controlled cross-over design, you have demonstrated positive effects of WG on muscular power, reaction times, antioxidant capacity and cortisol levels. The study provides a significative contribution to the literature on acute ergogenic effects of WG.

General Comments
The study's strengths include an appropriate experimental design, detailed and well-controlled methodology, adequate statistics and clearly presented results; however, some aspects could be improved:

a) The sample size (n=12) is relatively small, altough in line with similar studies. It would be usefull to include a justification of the sample size based on a power analysis. That is, an explanation of the reasons that led you to publish this study even with such low numbers, risking not having a publication.

b) It is not clear whether participants were instructed to maintain their normal sleep and physical activity habits during the study period. These factors could influence performance and should be controled or at least monitored.

c) The discussion could be enriched by more thoroughly comparing the results with previous studies on acute effects of other ergogenic supplements.

Specific Comments

• Lines 67-76: The recruitment process and inclusion/exclusion criteria could be described more in detail. In particular, it would be usefull to specify:
  a) How participants were recruited
  b) If they were physically active/trained
  c) Their level of experience with cycling exercise
• Lines 88-90: The choice of 90 minutes as pre-exercise administration time needs justification based on literature or pilot data. It seems a randomly defined choice.
• Lines 106 and 119: it is not clear to me why you chose 60 rpm for the maximal test while for training 100 to 120 at 100 to 120w. Can you clarify on which phisiological consideration you made this choice? Having two different pedaling rates without explanation makes me think that there is no scientific basis for this decision.
• Figure 3: I would suggest:
  a) Adding standard error bars
  b) Including p-values for significant comparisons
  c) Using more contrasting colors to better distinguish conditions
• Lines 219-256: The discussion of physiological mechanisms underlying the observed effects could be expanded, particularly regarding: a) The role of antioxidants in physical performance b) The interaction between cortisol and cognitive function c) The possible mechanisms of action of ginsenosides
• "Data Availability Statement" section: It is necessary to specify where and how the study data can be accessible, in line with the journal's data sharing policies.

 

The manuscript represents a valid and well-executed contribution to the scientific literature in the field of sports nutrition and ergogenic aids. With the suggested modifications, it will be even more informative and usefull for readers; if the authors will work on these suggestions I will carefully read the new version to give a definitive judgment which today is not completely positive.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for the opportunity to review the text entitled: Acute Effects of Wild Ginseng Extract on Exercise Performance, Cognitive Function, and Fatigue Recovery: A Randomized Randomized, placebo-controlled, double-blind study. The paper submitted for review is a description of a small experimental study to illustrate the utility of ginseng extract as an ergogenic ingredient. The research is interesting, however, the manuscript itself was prepared incorrectly and many elements need improvement. 

1. abstract: is written in an unclear manner. Please clearly present the aim of the work, its protocol and the most important results. Please add the correct botanical name of the plant that was studied in the paper. The last sentence of the abstract is redundant. 

2. introduction: the notation in lines 37-38 is completely misleading - what do the numbers in square brackets mean? In the entire introduction, the correct botanical name of the plant is not comprehended, nor is it indicated how Korean ginseng differs from others. 

3. Material and methods: this chapter (as well as the results) will need the most corrections. Figure 1 is completely redundant. Figure 2 (and all figures) is incorrectly captioned. Each table and figure must meet the principle of self-description and be understandable even after cutting from the manuscript. 

Please use impersonal forms of speech and present descriptions in the past tense. There is a lack of introduction of abbreviations - authors immediately use abbreviated notations. In many places there is a lack of information about the models of equipment that was used in the research. Notation: before, during, and after (line 142) - does not accurately inform about the study protocol. Chapters 2.7-2.9 require an indication of the source for the procedures presented there. 

In many places incorrect units are used for the results indicated. 

Line 185: what is the GS trial

Figures 3-5 are incorrectly described and thus unreadable. It is worth indicating the important difference in them by adding symbols. It is also worth indicating in the results (or in the supplementary materials the results in the form of mean and SD values, since in many places the figures alone are not convincing for the presented results of the statistical analysis). 

I don't know where the ART results and cortisol concentrations came from - the methods section didn't indicate any information about these measurements. For TAC, the name of the manufacturer of the kit was not given. 

Were baseline differences in cortisol concentrations analyzed? The trends of change shown in the figure appear to be identical for both groups. 

The grant number is incorrectly shown. 

References were incorrectly prepared. 

Nowhere did I find information on the double-blind protocol. 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The description of the background, methods, results, discussion and limitation of the study is generally clear and easy to understand. The figures can be improved as they lack the information needed to make sense of the data. As this is a study with a relatively small number of patients (n=12), the raw data should be presented individually as much as possible.

1.Figure 2.

Explanation of words such as BW, S&P and COG (figure legend) is needed.

2.Figure 3-6.

Figure 3-6 shows only the mean value, making difficult to understand the significance of the figure. At the very least, the mean ± standard deviation should be described, but it would be better to express (in addition perhaps) the transition of the data in each individual. It would be of interest to see what the change in individual subjects is in response to the actual drug or placebo.

Some subjects may have the same effect with placebo and with the actual drug. Some patients may have a poor effect in either case. Another patient could only benefit from the actual drug. The overall picture provides new and valuable information.

Is it possible that which intervention was performed first could affect the results? Information on the order of interventions for each subject would also be helpful.

It is also advisable to include P-values or symbols such as * for P-values.

3.Table 3.

It is easier to understand if BMI is also included.

What was the usual physical activity level of the subjects? The implications of this intervention (physical activity) are likely to be different for subjects who exercise more and those who exercise less. Explanations and considerations regarding the load on baseline physical activity are needed.

 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Dear authors,

I have read the revised text very carefully, and in this form, I believe it has regained a stronger coherence. In this form, I have no reservations regarding the request for publication.

Author Response

Comments: I have read the revised text very carefully, and in this form, I believe it has regained a stronger coherence. In this form, I have no reservations regarding the request for publication.

Responses: Thank you very much for your valuable comments on our manuscript. We truly appreciate your thorough feedback, which we believe will significantly enhance the quality of this manuscript.

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors, thank you for making numerous corrections, which improved the quality of the manuscript in an excellent way. It is important to point out a few elements that are still controversial: 

1. please indicate the full botanical name of the plant viz:  Panax ginseng C.A.Meye. L - this name should be shown in its full form only at the first indication in the manuscript (in the introduction) - each subsequent indication can contain the abbreviation (P. ginseng) or the English name 

2 I ask for a homogeneous form of writing the p-value throughout the manuscript: lowercase, italics - full numerical value - with 0 before the comma. 

3. any abbreviation that appears in the text must be introduced beforehand - such as VO2 max - please use the full name, then indicate the abbreviation in parentheses and use the abbreviation in turn. 

4. please remove periods from the ends of titles of tables and figures 

5. please modify the titles: these titles should not contain abbreviations, and if they do - they should be explained. This is the principle of self-description - the table and figure must be fully understood after cutting them out of the manuscript. Additional clarification is required for the title: Composition of WG and Placebo - in its current form, it indicates that the table contains a description of the subjects who were in the WG group and the placebo group. Perhaps a better solution would be to use the title: “Composition of test dietary supplement (WG) and placebo”.

6. Table 2 contains the results of HPLC analysis, which was not indicated as part of the study. Were these determinations performed by the authors of this paper? If so, this should be described in the methods section. A full description of the analysis and equipment used should then be indicated. If it was performed in an external laboratory - indicate who performed the determination. 

7. My last but most important comment concerns the analysis of cortisol concentrations. The graph clearly shows that the baseline values for WG and placebo are different. The standard deviations do not overlap at any point. Therefore, I would very much appreciate a re-analysis of the results for cortisol. Its baseline concentration seems to be a factor in the final outcome of the study - so I ask for an extended statistical analysis using the ANCOVA model. 

 

 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The manuscript has been improved.

Author Response

Comments: The manuscript has been improved.

Responses: Thank you very much for your valuable comments on our manuscript. We truly appreciate your thorough feedback, which we believe will significantly enhance the quality of this manuscript.