Reviewer ’s report  
 
Title: The effect of brisk walking on postural stability, bone mineral density, body weight and  
composition in women over 50 years with a sedentary occupation: A randomized controlled trial  
 
Version: 1 Date: 23 Mar 2016  
 
Reviewer: Simone V. Gill  
 
Reviewer's report:  
 
In this article, the authors examined the effects of a brisk walking (BW) intervention on postural 
ability (COP), bone mineral density, BMI, and body composition in a cohort of women. The 
authors provide interes ting information that adds to the literature on solid, quantitative outcomes 
that assess the effects of physical activity interventions. However, I think that the authors need to 
clarify and add information to the existing manuscript.  
 
Specific comments  
1. Please number the pages of the manuscript for ease of providing comments.  
2. P. 3, line 50: The authors mention briefly about the effects of overweight and obesity on fall 
risk and postural stability, but only list one reference. There is a growing litera ture in this 
area, which includes papers on fall risk1, postural stability2, and gait3,4 in relation to 
overweight and obesity. The authors should include more papers for a more thorough 
representation of the literature on this topic. Some examples of pape rs to cite are listed 
below:  
1. Gill SV, Narain A. Quantifying the Effects of Body Mass Index on Safety: Reliability of 
a Video Coding Procedure and Utility of a Rhythmic Walking Task. Archives of 
physical medicine and rehabilitation. 2012;93:728 -730. 
2. Singh D, Park W, Levy MS, Jung ES. The effects of obesity and standing time on 
postural sway during prolonged quiet standing. Ergonomics. 2009;52(8):977 -986. 
3. Hills AP, Hennig EM, Byrne NM, Steele JR. The biomechanics of adiposity --structural 
and function al limitations of obesity and implications for movement. Obesity reviews : 
an official journal of the International Association for the Study of Obesity. 
2002;3(1):35 -43. 
4. Gill SV. The impact of weight classification on safety: timing steps to adapt to e xternal 
constraints. Journal of musculoskeletal & neuronal interactions. 2015;15(1):103 -108. 
3. P. 4, line 1: There are a few papers that discuss improvements in gait following massive 
weight loss after bariatric surgery5,6. The authors should cite these p apers to better reflect 
the literature on weight loss and gait.  
5. Vincent HK, Ben -David K, Conrad BP, Lamb KM, Seay AN, Vincent KR. Rapid changes 
in gait, musculoskeletal pain, and quality of life after bariatric surgery. Surgery for obesity 
and related d iseases : official journal of the American Society for Bariatric Surgery. 
2012;8(3):346 -354. 
6. Vartiainen P, Bragge T, Lyytinen T, Hakkarainen M, Karjalainen PA, Arokoski JP. 
Kinematic and kinetic changes in obese gait in bariatric surgery -induced weight loss. Journal 
of biomechanics. 2012;45(10):1769 -1774.  
 
4. P. 7, line 23: There seems to be a typo here, "toadied." Did the authors mean to write "to 
aide?"  
5. P. 8, line 20: Could the pedometers also be used to create categories that reflect walking 
intens ity (e.g., 7)? This information could be very useful in determining how vigorous the 
intervention was for individual participants.  
7. Marshall SJ, Levy SS, Tudor -Locke CE, et al. Translating physical activity 
recommendations into a pedometer -based step goa l: 3000 steps in 30 minutes. American 
journal of preventive medicine. 2009;36(5):410 -415. 
6. P. 8, lines 38 -40: Did the authors examine variability (e.g., coefficient of variation) in the 
COP values? It would be interesting to note whether participants' CO P values either 
increased or decreased in variability from the baseline to after the intervention and also from 
trial 1 to 2.  
7. P. 10, line 34: Were there corrections for experimentwise errors included such as Bonferroni 
corrections?  
8. P. 11, lines 12 -20: The authors report an interesting result, but it is not clear to me that they 
can report a finding with a p=.034 if they say in the statistical analysis section that their 
cutoff was p=.01 for significance.  
9. P. 12, Where are the results for the post -intervention pedometer data, or comparisons of 
baseline and post -intervention pedometer data?  
10. P. 12, The figures show up as having poor quality. I am not sure if this is due to the 
uploading system or if the authors need to increase the quality of their  images.  
11. P. 13, line 51: There is a typo here. It should say, "The nature of the intervention that PA 
belongs to…"  
12. P. 15, line 8: The authors need to remove the comma and include an "and" in between 
Murphy and Hardman.  
13. P. 16, line 7: The author s should elaborate on how they believe that BW intensity can 
influence the results of a BW intervention. Their response can be supported by adding 
intensity data (see comment #5).  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional s tatistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary  from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publicatio n of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declar e that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
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