Effect of Real-Time Online High-Intensity Interval Training on Physiological and Physical Parameters for Abdominally Obese Women: A Randomized Pilot Study
Round 1
Reviewer 1 Report
# Review
The major concern is the small study sample. Therefore, sample size and power of the study need to be explained. Also, English revision is strongly recommended. Other remarks are as follows:
- The typographical error in the Title should be corrected.
- Line 48: the abbreviation „ACSM“ should be explained. The same is needed in line 154 for „TC, TG, HDL, and LDL analysis“.
- Line 77-78: Instead of „abdominal obesity women“, it should be corrected so as to be „women with abdominal obesity“.
- Line 89: „(BMI) of 25 or higher“-units are missing.
- Line 163- The following reference is not appropriate: „Cohen (1983) [28].“
- Line 170: Beside the version of the software, complete information on the manufacturer of the statistical software should be provided.
- The Authors should start the Discussion section by summarizing the main findings of their study. The Aim of the study has already been mentioned before.
- Line 268: „The International Diabetes Federation (IDF) proposed that empirical evidence is needed for prescribing combined exercise programs for the prevention of diseases caused by demographic changes [36]“- the reference is not appropriate.
- Line 282: „Fabian and Elena emphasized ... [42]“-the reference is not correct.
- Line 304: „Karin reported...“- only reference [27] should be cited, but not [46, 47].
Author Response
# Review 1.
Thank you for your valuable opinion during your busy time. I have revised the contents and want a review.
1. The major concern is the small study sample. Therefore, sample size and power of the study need to be explained:
-> In order to compare the effect size of this study, Cohen's d value was calculated and modified as follows.: Line 177
-> In addition, Cohen's d value was obtained to compare the reference values between groups. Table 3-7.
- The typographical error in the Title should be corrected:
-> I made a big mistake. I revised it as below.
-> Effect of Real-time On-line High-Intensity Interval Training on Physiological and Physical Parameters for Abdominal Obese Women: A Randomized pilot study - Line 48: the abbreviation ACSM should be explained. -> I revised it as below
-> American College of Sports Medicine (ACSM) : Line 48
- The same is needed in line 154 for „TC, TG, HDL, and LDL analysis“. -> I revised it as below
-> Total Cholesterol; TC, Triglyceride; TG, low-density lipoprotein cholesterol; (LDL) cholesterol, High-density lipoprotein(HDL) cholesterol : line 154
- Line 77-78: Instead of „abdominal obesity women“, it should be corrected so as to be „women with abdominal obesity“. -> I revised it as below
-> Thus, this study aims to investigate the effects of real-time, non-face-to-face HIIT on body composition, abdominal obesity, muscle strength, blood lipid profile, and stress index in women with abdominal obesity. : Line 77-78
|
6. Line 89: „(BMI) of 25 or higher units are missing. -> I revised it as below 7. Line 163- The following reference is not appropriate: „Cohen (1983) [28] -> I revised it as below and add reference : Line 163 & 457 |
- Line 170: Beside the version of the software, complete information on the manufacturer of the statistical software should be provided.-> -> I revised it as below : Line 170
-> The reliability (Cronbach’s α) of the PSS used in this study was 0.83, and it was processed using SPSS 22.0 software. - The Authors should start the Discussion section by summarizing the main findings of their study. The Aim of the study has already been mentioned before. -> I revised it as below : Line 228
-> This study investigated the effects of online high-intensity interval training (HIIT) on women's body composition, abdominal obesity, muscle strength, blood lipid profile, and stress, and confirmed that online HIIT for 8 weeks had physical and psychological effects compared to MICT participants - Line 268: „The International Diabetes Federation (IDF) proposed that empirical evidence is needed for prescribing combined exercise programs for the prevention of diseases caused by demographic changes [36]“- the reference is not appropriate.
-> I changed the contents and references as follows. : Line 228
-> Exercise combined with resistance and HIIT in the elderly improved LDL-C, insulin, and HOMA-IR profiles compared to moderate-intensity exercise, and is the same as in this study [47].
-> Da, S, M., Baptista, L, C., Neves, R, S., De, França, E., Loureiro, H., Lira, F, S., Caperuto, E, C., Veríssimo, M, T and Martins, R, A. (2020) The Effects of Concurrent Training Combining Both Resistance Exercise and High-Intensity Interval Training or Moderate-Intensity Continuous Training on Metabolic Syndrome. Front. Physiol. 11:572. doi: 10.3389/fphys.2020.00572 [47] - Line 282: „Fabian and Elena emphasized ... [42]“-the reference is not correct.
-> I changed the NAME.
-> García emphasized that physical activities and … [42]. : Line 284 - Line 304: „Karin reported...“- only reference [27] should be cited, but not [46, 47].
-> I changed the references as follows.
-> Karin reported that there are no cases of acute injuries reported among women who participated in HIIT and that participants can be engaged in the program by adjusting the exercises and rest intervals as they liked [27].
Author Response File: 
Author Response.docx
Reviewer 2 Report
The aim of this study was to investigate the effects of high-intensity interval training (HIIT) in women with abdominal obesity who had health complications associated with COVID-19. This study was a pilot study to test the effectiveness of HIIT training without the use of a computer, with the aim of analysing the feasibility and sustainability of the results obtained
Significant differences were found in levels of body fat, BMI and visceral fat between participants in both groups. Significant differences were also found in changes in blood glucose and lipids 254 between participants in both groups, particularly in insulin and LDL levels. Finally, participants in the HIIT group showed a marked reduction in the stress index, confirming that HIIT has greater psychological benefits than MICT.
A great advantage of the presented work is the fact that it considers not only physiological but also psychological factors of the studied group. It should be noted that other factors that were not controlled for in this study may have had an impact on reducing the level of perceived stress among the participants, but the results are relevant to the authors' aim.
A major limitation of the study is the small sample size. Therefore, the results and their interpretation should be treated very carefully. Rather as preliminary results. The statistical methods used are appropriate and the results presented are clear to the reader.
The manuscript, in my opinion, is ready for publication. To improve the quality of the manuscript, it indicates possible corrections to the authors:
1/ the bioethics committee approval number should be completed, which in my version of the manuscript contains only "*"
2/ it would be useful to supplement the manuscript with an explicit subsection on the limitations of the study
Author Response
# Review 2.
Thank you for your valuable opinion during your busy time. I have revised the contents and want a review.
1/ the bioethics committee approval number should be completed, which in my version of the manuscript contains only "*"
-> I revised it as below : Line 92-95
-> Korea National Sports University (1263-202106-BR-011-02). Contents including the purpose of the study, anonymity of participation in the study, voluntary participation, and possible abandonment were explained, and voluntary consent was obtained to protect the study participants.
2/ it would be useful to supplement the manuscript with an explicit subsection on the limitations of the study
-> I revised it as below : Line 308
-> Thus, subsequent studies should further validate HIIT to expand the scope of its benefits, and should continue to examine high-quality online exercise programs focused on specific groups of people, such as those with musculoskeletal disorders, geriatric diseases, and disabilities, such that HIIT can be utilized as a means to maintain public health in the post COVID-19 era.
Author Response File: Author Response.docx
Reviewer 3 Report
The paper is well structured and well founded, the results are very valuable and publishable, however I have the following observations.
1. The title and the objective have to be more related.
2. Was the research protocol endorsed by a bioethics committee?
3. There are some grammatical errors for example in line a 91 (were enrolled. And this study)
4. In the description of the results, the p value is not unified, for example in line 181 (p = .036) and in line 199 (p = 0.011).
5. It is important to consider that all those studies in which the participation of a person is involved must be validated by a bioethics committee that is legally constituted.
6. It is important that the authors corroborate the results obtained through the applications of cell phones or smart watches with measurements of equipment and instruments specifically designed for this purpose.
7. It is important to calculate a sample size that ensures that the results and their analyzes are statistically representative and can be used to make inferences about a population.
Author Response
Thank you for your valuable opinion during your busy time. I have revised the contents and want a review. Thank you.
1. The title and the objective have to be more related.
-> ERR revised it as below : TITLE
-> Effect of Real-time On-line High-Intensity Interval Training on Physiological and Physical Parameters for Abdominal Obese Women: A Randomized pilot study
Was the research protocol endorsed by a bioethics committee?
-> I revised it as below : Line 92-95
-> Korea National Sports University (1263-202106-BR-011-02). Contents including the purpose of the study, anonymity of participation in the study, voluntary participation, and possible abandonment were explained, and voluntary consent was obtained to protect the study participants.
There are some grammatical errors for example in line a 91 (were enrolled. And this study)
-> I revised it as below : Line 92-95
-> Korea National Sports University (1263-202106-BR-011-02). Contents including the purpose of the study, anonymity of participation in the study, voluntary participation, and possible abandonment were explained, and voluntary consent was obtained to protect the study participants.
In the description of the results, the p value is not unified, for example in line 181 (p = .036) and in line 199 (p = 0.011).
-> visceral fat level: The visceral fat level is an item that shows the cross-sectional area as a level. It means 1 level per 10cm² of visceral fat, so 6 levels mean 51-60cm of visceral fat. line 181 (p = .036)
-> Therefore, it is a different measure from the circumference of line 199 (p = 0.011).- It is important to consider that all those studies in which the participation of a person is involved must be validated by a bioethics committee that is legally constituted.
-> Contents including the purpose of the study, anonymity of participation in the study, voluntary participation, and possible abandonment were explained, and voluntary consent was obtained to protect the study participants. I revised it as below : Line 92-95
-> and this study was approved by the institutional review board at k University (1263-202106-br-011-02).
6. It is important that the authors corroborate the results obtained through the applications of cell phones or smart watches with measurements of equipment and instruments specifically designed for this purpose.
-> This study is an online exercise conducted in the COVID-19 situation, and prior studies are very insufficient. Therefore, it was not possible to use specially designed equipment. In this study, real-time exercise intervention was performed using zoom. However, there is a possibility that it may be misunderstood as a promotion of the company, so it was not marked.
7. It is important to calculate a sample size that ensures that the results and their analyzes are statistically representative and can be used to make inferences about a population.
-> In order to compare the effect size of this study, Cohen's d value was calculated and modified as follows.: Line 177
-> In addition, Cohen's d value was obtained to compare the reference values between groups. Table 3-7.
Author Response File: Author Response.docx
This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.
Round 1
Reviewer 1 Report
See attached
Comments for author File: 
Comments.pdf
Reviewer 2 Report
This study aimed to investigate the effects of smart device-based intervention in sedentary women experiencing health complications during the COVID-19. I see some value of this article, but there are still many problems concerning this study. For example, the sample size of the intervention was too small, and the author did not calculate the sample size required to achieve statistically significant effects through G-Power software. The detailed questions are shown below:
- Line 19: “Thus, smart device-based HIIT is a useful means to alleviate abdominal fat induced by sedentary lifestyles, improve blood lipid profile, and muscle strength, and relieve stress caused by COVID-19.”
I don't think this description is accurate because we don’t know if the health complications (e. g. stress) were caused by the COVID-19. The author needs to modify the description problem of the whole article because the participants in this study are not COVID-19 patients, so the health complication were caused not only by COVID-19, but maybe other reasons.
- 2 Experimental procedure
Line 114: “The total calorie consumption was equal for both groups, ……”
One of the purposes of the study should be compare the health benefit of two kinds of training. So, it is important to set the program of HIIT and MICT. How did the author control the equality of calorie consumption of two groups and how much calories did they spent? The author should tell the details about it. Otherwise, the author couldn’t get the current conclusion.
- This is a smart device-based exercise program in the epidemic situation. There are two important points in order to compare the intervention effects of MICT and HIIT. Firstly, how does the author consider the impact of the other exercises of participants beyond the author’s intervention program? Secondly, abdominal fat, BMI, blood glucose and other indicators are largely affected by diets. How to eliminate the interference of subjects’ diet factors
- The control of the intervention process is very important in this study. It is suggested that the author describe in details about how to control the compliance of all subjects in the whole intervention program.
- Figure 2,3 and 4 shows incomplete.
- The conclusion of the study was HIIT led to significant changes in body fat mass, BMI, and visceral fat level and markedly reduced abdominal subcutaneous fat thickness, abdominal circumference, and hip circumference compared to MICT. However, the author did not deeply analyze why HIIT can improve these indicators better than MICT in the discussion part. It is suggested that the author explain more deeply why HIIT has advantages than MICT in the discussion.
