Intensive Rehabilitation Program in Arterial Occlusive Disease Patients

Round 1

Reviewer 1 Report

This is a well-organized study for determining the efficacy of intensive eleven-day rehabilitation program on behavior and symptoms in patients with Peripheral arterial occlusive disease (PAOD). The results are impressive and encouraging for the patients.

One of the problems is a small sample size of both stretching Group (SG) and conditioning Group (CG). The authors should describe the limitation of the study.

I totally agree with the authors that an intensive eleven-day rehabilitation program based on walking, strength and stretching exercises is effective to improve the onset and the delay of pain during walking in patients with PAOD. In accordance with Gardner et al. and Hamburg et al. [l. J Am Geriatric Soc. 2001;49(6):755–62. . Circulation. 2011;123(1):87–97.], author’s results demonstrated that the use of 183 treadmill exercise into the rehabilitation program to ameliorate ICP and ACP. However, the elderly patients with PAOD do not always perform intensive exercise including treadmill walking. This type of limitation also should be described.

Author Response

Please see the attachment

Author Response File: Author Response.docx

Reviewer 2 Report

An interesting study looking at the effect of exercise interventions on functionality of patients with peripheral arterial occlusive disease. The results demonstrate no additional effect of a stretching protocol, on top of walking and strength training, on measures of gait. I have several things for the authors to improve on. Furthermore, there are minor English language errors throughout. These didn't prevent me from understanding what you meant, and hopefully these will be corrected in copy-editing.

General comments:

Abstract, lines 25, 26. Is there some of the statistical analysis you can insert here to back up the statement?

Introduction, line 56. Mixing up two referencing styles here.

Introduction, lines 61-64. Could you turn this into more of a formal hypothesis?

Method, line 67. I would find it more useful to have the anthropometric characteristics of the participants here, rather than in the results.

Method, line 112. I don't think this needs a separate subheading and I feel it would be better if it were not in bullet points.

Method, line 124. What is dump action?

Method, line 127. What is the rationale for using this 11 day protocol? It seems quite a random number. 10 days or 14 days would seem more typical durations. Please provide rationale and justification.

Method, line 139. Why use two different calf stretches? Do they target slightly different muscles within the calf? Is one a progression of the other? Is one more effective than the other?

Method, line 154. I would suggest using the ∆ symbol, rather than writing out delta.

Results, line 168. If there was no significant difference in the CG, please remove mention of them improving.

Results, line 170. Not something you have to change, but I feel readers often get a better handle on results when they are presented in figures rather than tables.

Discussion, line 186. This needs to be made clearer. Do you mean that there is a lack of previous data finding an effect of overground walking? The way it is written makes it seem like your data demonstrate a lack of effect, but in the next sentence you say you did see an effect.

Discussion, line 198. Your results don't back up this statement. There were no significant differences in improvement between the groups.

Discussion, line 200. You didn't measure balance.

Discussion, line 202. Why didn't you do those things?

Author Response

Please see the attachment

Author Response File: Author Response.docx