Title: Effects of Pilates on Inter-recti Distance, Thickness of Rectus Abdominis, Waist
Circumference and Abdominal Muscle Endurance in Primiparous Women
Version: 3 Date: 17 Jul 2023
Reviewer's report:
Reviewer comment
Journal: BMC Women’s Health
Title: Effects of Pilates on the Inter-recti Distance, Thickness of Rectus Abdominis, Waist
Circumference and Abdominal Endurance in Primiparous Women
Although the idea is interesting, the manuscript was not adequately written.
The problem and inclusion criteria were not clear. So, it was not clear for the readers that the
study is preventive or curative treatment. Results did not demonstrate any pre-treatment and
pos-treatment values of the variable measured and within group comparison. It focused only on
comparison of mean difference. Also, Methods needs more details and discussion needs to be
improved.
Title:
Delete the word “the”.
The authors mentioned “abdominal endurance” in the title, while in the manuscript it was
mentioned as “back endurance”.
Abstract:
• It needs to be rewritten.
• Write a background for your study.
• Method: What did the control group receive??
• Results: What were the results of the control group?
• Demonstrate your results it as increased or decreased with p-values.
• Conclusion: Be concise and focus on your findings stating clinical implications.
Introduction:
• The problem of the study is not clear.
• Please, focus on your problem, write incidence, causes, patho-mechanical changes, treatment.
• Pilate exercise and its safety of using it after 2 months of labor supporting it with reference
and its effect based on previous studies (what are the findings of previous studies) stating the
gap in the literature review.
• Please, do not mention in detail about method used such as ultrasound in introduction.
Methods:
-Most methods were not clear. For example, and not limited to the following:
-“We recruited 28 participants in the exercise group and 17 in the control group due to difficulties
in identifying subjects who met the inclusion criteria”.
-Why did you mention that you have difficulty in identifying subjects??
-Did you calculate the sample size for your study? Please mention it?
Inclusion criteria: The authors did not mention baseline criteria of the participants, inter-recti
distance to know if the patients had rectus diastasis or not and how was this diagnosed???
Exclusion criteria were not clear. what about patients with low back pain, diabetes, hypertension
etc….
Why did you exclude those newborns weighed 2.5 kg or less at delivery????
Delete “The section of study procedures”. Because there were some information has been
reported before.
Exercise intervention
• It needs to be more organized and delete unneeded information.
• Please, Give brief a description about each exercise.
• Describe in brief progression pf PRE.
• Write number of repetitions and sets of exercise.
• Write which materials used with supporting reference only? Such as paragraph of
• Referring to a previous study…….. be concise.
• After each self-exercise, the researcher asked the subjects to report whether it was fully
completed via message and to participate in at least 90% of the self-exercise session??
How did you determine that she performed 90 % of the exercise?
• Also, what was the compliance of participants to exercise under supervision??
Instrumentation and examiners
• You can replace it with a title of Outcome measures. Then, you can insert subtitles for your
outcomes such as “Assessment of   inter-recti distance and thickness, ect…
• Write validity and reliability of ultrasound?  How did you ensure standardization of repeated
measurements of ultrasound?
• What is the name of the test of endurance used, write validity and reliability of this test, describe
it adequately, what is the outcome measured using this test, is it abdominal or back or anything
else….
Data analysis
• Methods of data analysis should be revised with a statistician.
• Is your data homogenous and normally distributed??
• The authors satisfied with between mean difference comparison. This is not enough.
Results
• You should mention pre-treatment and pos-treatment data in a table. And report within group
comparison of each group (Control and study) with p-value.
• Please, mention interpretation of the results of for each group (control and study) with p-value.
And then mention comparison between group.
Discussion
• Please, don not mention causes of selection your patients and causes of using your methods.
• Please, focus on the aim of the study, your findings.
• Demonstrate findings of the control group and supporting studies giving appropriate
explanation. Then findings of the Pilate studies reporting studies agreed and disagreed with you
giving explanation of the findings.
• Discussion mentioned some findings of within-group comparison such as waist circumference,
while it was not reported in the results. You should report it in the results section.
• Mention limitations and further studies.
• Please revise your limitations mentioned. Some limitations that you have reported can be
provided in the present study such as correlation of inter-recti distance and other variables.
Because you have data for all these variables. So, you can conduct it and provide it in the section
of your results. This will provide more strength to your study and may provide explanation of
your findings.
Conclusion
• Focus on conclusion only. Delete purpose of the study and any suggestions of suggestion of
further study from your conclusion.
English
The manuscript needs proofreading, and grammar checker.
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