Title: Effects of Pilates on Inter-recti Distance, Thickness of Rectus Abdominis, Waist
Circumference and Abdominal Muscle Endurance in Primiparous Women
Version: 3 Date: 16 Jul 2023
Reviewer's report:
Thank you for allowing me to review this manuscript titled: Effects of Pilates on the Inter-recti
Distance, Thickness of Rectus Abdominis, Waist Circumference and Abdominal Endurance in
Primiparous Women
The objective of the study was to investigate the effect of pilates on interrecti distance (IRD),
thickness of the rectus abdominis (RA), waist circumference and abdominal endurance in
primiparous women.Thirty-five participants following primiparous women were assigned to
a pilates exercise group (n=20) and a control group (n=15). According to intervention, the
exercise group showed significantly improved results in all locations inter-recti distance, waist
circumference and abdominal endurance (p<0.001). Also, compared to the control group and
experimental group shows significantly improved performance for inter-recti distance, waist
circumference, abdominal endurance
The results of this study demonstrate that pilates was effective in reducing inter-recti distance
and waist circumference and improving abdominal endurance.
The topic of your study is very interesting.
I have several concerns about your manuscript.
I highly recommend that you follow the recommended guidelines CONSORT 2010 and include
a checklist . The manuscript has some  grammatical errors; I recommend revising it.
Here are some additional comments:
1. Background:
Not all women have dysfunction, pain, and poor posture. I suggest rephrasing the sentence
because  it seems that all the pregnancies are pathological.
I recommend avoiding phrases like "in many cases" when discussing percentages. How many
women actually recover spontaneously and when?
I would avoid writing that "women" are interested in Pilates and instead use more inclusive
terms.
2 Methods: regarding the participants, I kindly request clarification on the inclusion and
exclusion criteria. What do you mean by "normal asphyxiation"?
There is a lower limit in newborn weight, but have you considered a maximum weight as an
exclusion criterion? Clearly, a macrosomic fetus has an impact on the abdominal wall.
2 months after childbirth till? You mentioned a limit of 12 moths in the discussion capitel not
here.
But the most important  is the description of trial design  and the eligibility criteria . You can
improve  this  if you follow the recommended guidelines for authors.
Can you explain why you included women who had undergone a cesarean section when the
procedure has a direct impact on the abdominal wall? Cesarean sections can be performed via
Pfannenstiel incision or through a midline laparotomy. Each technique affects the abdominal
wall healing differently. Could you explain your reasoning behind this?
Another important question that needs to be answered is : How sample size was determinate?
3. Discussion, you mentioned body fat and how they have observed a decrease in waist
circumference. The participants in the study have an average BMI of 21, 17, and 21.24 in
both groups. A very good BMI 5 months after childbirth. Are these results extrapolatable to
overweight and obese patients?
I hope you  continue with you research and I wish you good luck. More research is needed in
this field. Best regards