Changes of Gait Patterns after Correction of Refractive Error in the Elderly with Cataracts

Round 1

Reviewer 1 Report

Abstract: The aim can be rewritten in a positive sentence like "The aim of this study was to verify whether providing older adults with actual corrected glasses for refractive errors would have a positive impact on their gait patterns."

Kindly recheck and keep the terminologies consistent throughout the text e.g. after wearing corrected glasses (Line 12-13), after wearing correction glasses (Line 16)

Introduction: The introduction section is well written however, there are a lot of details that are missing. 

What is the novelty of this study? 

What does the "limited experimental conditions" mean (Line 63)? How it corelate or your study cover this part. 

What does the term "within the past year" (Line 68) refer to? As the results did not highlight any results that talk about the past year compared to recent data collected.

Methods:

How did authors calculate the sample size (Line 71)?

There is no any figure showring Optogait gait analysis system "Fig.1" (Line 89)

How these sentences corelate with the study methods " Analysis of various" ..... "using this system" (Line 91 - Line 94). Did the authors use treadmill in this study?

Results & discussion:

Why the cadence decreased? As in previous studies showed increased cadence. How it can corelate with increased step length. 

Kindly recheck the p value for step length before and after as mean value have minor difference compared or stride length.

I would suggest giving a brief summary of your results in the first paragraph of discussion section including aim. 

Conclusion:

How the walking velocity increased in the conclusion section as it contradict with the statements mentioned in the results (Line 136-137), (Line 144-145), (Line 149)

 

Kindly keep it consistent for terminologies e.g. (Figure 2) (line 196 & line 145) or 

 

There are a few instances where the sentence structure could be enhanced for better clarity.

Author Response

"Please see the attachment."

Author Response File: Author Response.docx

Reviewer 2 Report

This study investigated the effects of correction of refractive error by glasses on gait patterns in older adults. The main finding of this study was that wearing the glasses improved their gait patterns such as increased step and stride length and decreased cadence. However, there was no significant correlation between visual improvements and gait pattern measurements. While this study showed interesting results, I feel that this manuscript needs some more context for a better understanding.

My major concerns are as follows:

1.      Title: This study targeted the elderly with cataracts. The title should change to “in the elderly with cataracts”.

2.      Line 14: r-value is important to evaluate the correlation. Please show both the r-value and p-value in these sentences.

3.      Why did the authors consider the correction of the refractive error to have a positive effect on gait patterns? Please explain it in the introduction with appropriate references in more detail.

4.      Line 80: What do the authors mean by the words “aided” and “unaided”? Is it the same as “with and without glasses”? Also, how were the subjects checked for their visual acuity?

5.      The authors should provide more information about the data analysis used to evaluate gait patterns, such as the differences between step and stride length. Additionally, the interpretation of the results should be supported with appropriate references to prior research in the field in the discussion session.

6.      The authors should consider not only the pace factor but also the variability or rhythm factor, which are more correlated with the experiences of falls in the elderly.

7.      How many trials were done with and without glasses? Was there any habituation period before subjects were tested? Also, please add an appropriate reference because the authors use 5-m walking paths. The distance is too short to analyze steady walking.

8.      The results of gait pattern measurements showed a large SD. I recommend the authors display effect sizes in Table 1.

9.      Line 143: The authors analyzed the correlation between changes in gait pattern measurements. If so, you should mention it in the analysis section.

10.  Correlation figure: The figure makes it appear as if there are outliers (1 to 3 persons) driving the correlation. It would be prudent to avoid over-emphasizing these results.

11.  The authors should mention the main research question and findings of this study in the first paragraph of the discussion in a brief way.

12.  Line 228: The authors should show the results of the correlation between visual improvements and gait pattern measurements as a figure to mention this limitation. Additionally, you should analyze the correlation between visual impairments and changes in gait pattern measurements.

13.  Please discuss the implications and practical application of your findings further in the discussion and not only in the conclusion section. For example, why did you consider these results to have effects on fall prevention?

14.  Please confirm the format in the reference section. Some references do not follow the formatting rule.

15.  There are some typos and grammar mistakes. I have listed a part of the mistakes in the minor points. Please re-check the whole manuscript.

Minor points:

1.  Line 36: Please remove extra space.

2. Figures: Figure 1 is duplicated.

3. Table 1: The last column should be walking velocity.

15.  There are some typos and grammar mistakes. I have listed a part of the mistakes in the minor points. Please re-check the whole manuscript.

Minor points:

1.  Line 36: Please remove extra space.

2. Figures: Figure 1 is duplicated.

3. Table 1: The last column should be walking velocity.

 

Author Response

"Please see the attachment."

Author Response File: Author Response.docx

Reviewer 3 Report

Dear authors,

I feel that this work is quite interesting and well done. I have nevertheless some minor comments.

Introduction: When you introduce gait pattern you don't mention step width, which is an important indicator of the quality of gait, with wider steps needed to increase gait stability.

Table 1: What is with (cm)? And the values of Width (cm) seem quite strange.

Table 2: What is with (cm)?

Discussion: Please analyse why step width has increased.

Moreover it would have been interesting to evaluate also other parameters linked to stable gait, such as the percentage of the gait cycle spent in double support.

Best regards

Please check English language. Moderate editing of English language is needed

Author Response

"Please see the attachment."

Author Response File: Author Response.docx

Reviewer 4 Report

Dear, 

the article is interesting and well written, 

fit with the topic of the journal, but minoro improvements are necessary before the publication, 

add a list of abbreviations

check the plagiarism of your paper

add the type of study in the title

check the grammar with a native english 

Regards

Dear, 

the article is interesting and well written, 

fit with the topic of the journal, but minoro improvements are necessary before the publication, 

add a list of abbreviations

check the plagiarism of your paper

add the type of study in the title

check the grammar with a native english 

Regards

Author Response

"Please see the attachment."

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Thank you for your positive responses to all the comments. Hope this work will benefit readers. All the best for future research work and collaborations. 

The MDPI editing team should look in detail. Overall, the Quality of English Language seems OK to me.