Stochastic Resonance Whole Body Vibration (SR-WBV) Does Not Affect the Body Composition of Healthy Young Women: A Preliminary Controlled Before–After (CBA) Study
, Magdalena Hartman-Petrycka 1, Barbara Błońska-Fajfrowska 1, Robert Koprowski 2 and Sławomir Wilczyński 1
Łukasz Kryst
Round 1
Reviewer 1 Report
In the manuscript “Stochastic Resonance Whole Body Vibration (SR-WBV) does not affect the Body Composition of Healthy Young Women: A Preliminary Controlled Before-After (CBA) Study” by A. Lebiedowska et al., the study of the influence of randomized vibrations of the whole body are given. The effect of randomized vibrations was tested over a group of young women by measurements of body masses and biomedical impedances relating to the fat and the fat-free body components. The authors have not observed reliable effects of whole body vibrations. Hence they conclude that randomized vibration procedure cannot be recommended as a way to modify the body composition in healthy young women characterized by normal body composition and low or moderate physical activity levels.
In my opinion, the study is helpful for the whole body vibration training and therapy. Overall, the manuscript is written well and clear, and may be published as it is.
At the same time, I would like to point out that the term “stochastic resonance” the authors use can lead to some misunderstanding. For the last decade, the term stochastic resonance has indeed been used in some medical articles to characterize the effects of randomized vibrations of the body on the tissues, metabolism, and neurophysiological activity. However, this term was originally introduced in physics (see original publication “The mechanism of stochastic resonance” ( J Phys. A: Math. Gen., 1981, 14, L453) by Benzi et al), and it is actively used in many fields, e.g., physics, chemistry, biophysics, nano-sciences, life sciences, and neurosciences. There are many reviews on physical phenomenon of stochastic resonance (see, for example, Gammaitoni et al, Stochastic Resonance. Rev. Mod. Phys. 1998, 70, 223). What is more, the term stochastic resonance in recent medical literature, of which the present paper is an example, has nothing to do with the physical phenomenon of stochastic resonance. In the medical literature, stochastic resonance is understood as the physiological response of the body to the impact of low-frequency randomized vibrations. In physical literature, the stochastic resonance is the phenomenon of strong regularization of spontaneous (random) vibrations of bistable dynamic systems subjected to the action of weak oscillating force of characteristic frequency. I see a confusion here. I would advise the authors to at least give some comments on the term stochastic resonance so as not to mislead readers.
Author Response
Agata Lebiedowska Ph.D. Sosnowiec, May 11th, 2023
Department of Basic Biomedical Science,
Faculty of Pharmaceutical Sciences in Sosnowiec,
Medical University of Silesia in Katowice, Poland
Dear Reviewer,
I am very grateful for the valuable opinions and remarks. I agree with our comment and I have referred to it as best as possible in a revised version of the manuscript.
- In the manuscript “Stochastic Resonance Whole Body Vibration (SR-WBV) does not affect the Body Composition of Healthy Young Women: A Preliminary Controlled Before-After (CBA) Study” by A. Lebiedowska et al., the study of the influence of randomized vibrations of the whole body are given. The effect of randomized vibrations was tested over a group of young women by measurements of body masses and biomedical impedances relating to the fat and the fat-free body components. The authors have not observed reliable effects of whole body vibrations. Hence they conclude that randomized vibration procedure cannot be recommended as a way to modify the body composition in healthy young women characterized by normal body composition and low or moderate physical activity levels.
In my opinion, the study is helpful for the whole body vibration training and therapy. Overall, the manuscript is written well and clear, and may be published as it is.
At the same time, I would like to point out that the term “stochastic resonance” the authors use can lead to some misunderstanding. For the last decade, the term stochastic resonance has indeed been used in some medical articles to characterize the effects of randomized vibrations of the body on the tissues, metabolism, and neurophysiological activity. However, this term was originally introduced in physics (see original publication “The mechanism of stochastic resonance” ( J Phys. A: Math. Gen., 1981, 14, L453) by Benzi et al), and it is actively used in many fields, e.g., physics, chemistry, biophysics, nano-sciences, life sciences, and neurosciences. There are many reviews on physical phenomenon of stochastic resonance (see, for example, Gammaitoni et al, Stochastic Resonance. Rev. Mod. Phys. 1998, 70, 223). What is more, the term stochastic resonance in recent medical literature, of which the present paper is an example, has nothing to do with the physical phenomenon of stochastic resonance. In the medical literature, stochastic resonance is understood as the physiological response of the body to the impact of low-frequency randomized vibrations. In physical literature, the stochastic resonance is the phenomenon of strong regularization of spontaneous (random) vibrations of bistable dynamic systems subjected to the action of weak oscillating force of characteristic frequency. I see a confusion here. I would advise the authors to at least give some comments on the term stochastic resonance so as not to mislead readers.
Answer: Thank you very much for your positive review and valuable comments. In the Introduction section, I added a sentence explaining the concept of stochastic resonance in this study, as suggested (lines 70-72).
Author Response File: 
Author Response.docx
Reviewer 2 Report
This manuscript uses the vibrating devices with stochastic resonance to generate vibrations of variable amplitude and frequency. For people with incorrect body composition who cannot undertake physical activity for various reasons, procedure with stochastic resonance seems to be a good solution. This manuscript evaluates the impact of stochastic resonance whole body vibration on the body composition of women. The study involved 240 healthy young women with normal body composition (BC) and low or moderate physical activity levels. The authors conclude that stochastic resonance vibration procedure cannot be recommended as a way to modify the body composition in healthy young women characterized by normal body composition and low or moderate physical activity levels.
This conclusion is not surprise for me at all. The SR-WBV was carried out only two times per week for 12 times in 6 weeks. The involved women between 18 and 35 years of age can be regarded as optimal systems, so the SR-WBV is ineffective. The experimental times are small.
In addition, why not test the body balance, the reaction capability of the experimental subject?
Author Response
Agata Lebiedowska, Ph.D. Sosnowiec, May 11th, 2023
Department of Basic Biomedical Science,
Faculty of Pharmaceutical Sciences in Sosnowiec,
Medical University of Silesia in Katowice, Poland
- This manuscript uses the vibrating devices with stochastic resonance to generate vibrations of variable amplitude and frequency. For people with incorrect body composition who cannot undertake physical activity for various reasons, procedure with stochastic resonance seems to be a good solution. This manuscript evaluates the impact of stochastic resonance whole body vibration on the body composition of women. The study involved 240 healthy young women with normal body composition (BC) and low or moderate physical activity levels. The authors conclude that stochastic resonance vibration procedure cannot be recommended as a way to modify the body composition in healthy young women characterized by normal body composition and low or moderate physical activity levels.
This conclusion is not surprise for me at all. The SR-WBV was carried out only two times per week for 12 times in 6 weeks. The involved women between 18 and 35 years of age can be regarded as optimal systems, so the SR-WBV is ineffective. The experimental times are small.
In addition, why not test the body balance, the reaction capability of the experimental subject?
Dear Reviewer,
I am very grateful for the valuable opinion. I agree with the comment and I will try to answer as best as possible.
These are our final conclusions: The SR-WBV procedure program with weak parameters used in this study is not enough as training stimulus in healthy, young women. However, we had treated the above studies as preliminary studies, also to check the safety of SR-WBV vibrations in healthy people, before the research were extended to people with abnormal body composition and the elderly.
We have already examined body balance in another study, after the stochastic vibrations characterized by the same parameters and with wider age range among participants and the improvement has been shown (body stability was higher; the SR-WBV was more effective in younger, taller and slimmer women – Donocik, et al. [1]). Actually, it allowed us to assume that SR-WBV with the same parameters will also improve body composition among young women. We assumed that the use of stochastic WBV, which showed higher muscle activation than sinusoidal WBV [2], would be sufficient. It turned out we were wrong. In the case of body composition, the procedure was insufficient.
Correct BMI values do not indicate an ideal body composition. We did not expect spectacular changes, but often normal body weight people have an upper limit in the percentage of body fat and, in turn, have a lower limit in the content of muscle mass. Our other study [3] showed how weak BMI is as an indicator of body composition. We selected for the study people declaring low and medium physical activity, assuming that they would be more sensitive to the vibration stimulus. However, it turned out to be too low. When planning further research, we already know for sure that the vibration parameters, length and frequency of sessions should be increased. To sum up, we tried to assess the safety of the vibrations, we assumed that the stochastic nature would allow the use of weaker vibration parameters than the standard sinusoidal WBV, reducing the risk of potential side effects [4] we also assumed that despite the correct BC, small changes in the content of muscle mass in people with an average and low physical activity will be revealed.
The study design is an element that we are unable to improve at this stage, after the research is completed. However, we decided to write about the failure of the experiment to draw the attention of other researchers. The manuscript was written precisely to show that the study design we used turned out to be incorrect/insufficient and the title of the manuscript indicates it. We believe that a publication is valuable, showing that a given method does not work is equally important and contributes a lot to science, and such publications are lacking. Perhaps, having access to similar other authors results, we would not have made a mistake and used a different research methodology.
[1] Donocik, K.; Hartman-Petrycka, M.; Lebiedowska, A.; Błońska-Fajfrowska, B. Alterations in the ability to maintain balance as a result of stochastic resonance whole body vibration in women. PLoS One 2017, 12(9), e0185179.
[2] Lauper, M.; Kuhn, A.; Gerber, R.; Luginbühl, H.; Radlinger, L. Pelvic floor stimulation: what are the good vibrations?. Neu-rourology and Urodynamics: Official Journal of the International Continence Society 2009, 28(5), 405-410.
[3] Lebiedowska, A.; Hartman-Petrycka, M.; Błońska-Fajfrowska, B. How reliable is BMI? Bioimpedance analysis of body com-position in underweight, normal weight, overweight, and obese women. Irish Journal of Medical Science (1971-) 2021, 190(3), 993-998.
[4] Hartman-Petrycka, M.; Lebiedowska, A.; Stolecka-Warzecha, A.; Szumski, A.; Błońska-Fajfrowska, B. The Influence of Sto-chastic Resonance Whole-Body Vibration on Women over 50 Years of Age—Preliminary Studies Based on Patients’ Own Ex-periences. Applied Sciences 2021, 11(9), 3980.
Author Response File: Author Response.docx
Reviewer 3 Report
The Authors decided to take into consideration the problem of using Stochastic Resonance Whole Body Vibration to modify the body composition of young, healthy women. In is a novel and important problem. However, the manuscript needs some improvements, which are listed below.
Detailed comments and suggestions:
- Abstract:
o there is no information what body composition parameters were taken into consideration;
o there is no information that the participants were randomised (there is such information on the CONSORT-type scheme in the later part of the manuscript);
o the term “abnormal body composition” is not precise enough and should be exchanged for a clearer one;
o “selected” in the description of the recruiting of the participants sounds as if they were consciously selected to take part in the study, which was not the case, based on the rest of the text; that should be corrected;
- Introduction:
o ll. 68-69 – the sentence is unclear and should be rewritten;
o l. 79 – the issue of safety is mentioned here; however, there is no mention of it in the aim of the study; additionally, no safety aspects are mentioned in the “Results” section, besides one sentence stating that no negative effects of vibration therapy were reported;
o ll.81-86 – the text should be moved to “Material and methods” section of the text, particularly, to the description of the study group;
o the numbering of the subsequent parts of “Material and methods” should be corrected;
- Material and methods:
o Study design:
§ the first line of the text repeats the information from the previous part of the text; it should be removed from the “Introduction” and only left in this part of the manuscript;
§ the information that the “…overall number of participants was random, and so the C and V group selection…” is not clear and should be rewritten; there is also a part of the sentence missing (maybe it should be “and so WAS the C and V group selection”?); do the Authors mean that the study groups were not equally distributed to during the randomisation process? The same sentence is then repeated in line 118;
§ the reasons for losing the participants from the study should be listed on the CONSORT-type graph;
o Study participants:
§ the description of the sample size is very chaotic and differs from one part of the text to another; for instance, first, the Authors write that the inclusion into study groups happened randomly, then that there were 280 participants in each group, then that there were 240 in total, and then, in lines 127-129, it says that the control was selected analogously to the 140 persons in the study group; then, the CONSORT-type graph represents one more version of the number of individuals in the study;
§ were the exclusion criteria formatted as bullet points? This part of the text should be formatted properly and/or rewritten;
§ the Authors state that “Volunteers who met all inclusion and exclusion criteria…”; if the participants met any of the exclusion criteria, they should be excluded from the study – the sentence should be corrected accordingly;
§ detailed reasons for losing the study participants should be provided in the text;
§ the characteristics of the study group together with the description of the study flow (participants lost from the study etc.) should be presented in the “Results”, not “Material an methods”;
o Body Composition Analysis:
§ the description of the principle of estimating the amount of tissues by BIA is very simplified, and thus not completely correct;
§ there is no information regarding the tools used for measuring the height and weight of the participants; additionally, the accuracy of the measurements, as well as the method (Martin, IBP etc.) should be provided;
o Statistical Analysis:
§ the precise type of ANOVA used for the analysis should be provided in the text;
- Results:
o it will be beneficial to provide total body fat in the table containing the basic characteristics of the sample;
o the descriptions below the tables should end with a period, not a coma;
o it will be helpful to present differences (baseline vs the last follow-up) in tables 2, 4 and 6;
o Table 2 – there is no sufficient information on the p-value; what is the difference that it indicates (within groups, between groups etc?)?
o the description of the body water parameters is connected to the description of Table 6;
- Discussion:
o a person first language should be used throughout the text
Author Response
Agata Lebiedowska, Ph.D. Sosnowiec, May 11th, 2023
Department of Basic Biomedical Science,
Faculty of Pharmaceutical Sciences in Sosnowiec,
Medical University of Silesia in Katowice, Poland
Dear Reviewer,
I am very grateful for the valuable opinions and remarks. I agree with all the comments and I have referred to them as best as possible in a revised version of the manuscript. List of corrections is presented below:
The Authors decided to take into consideration the problem of using Stochastic Resonance Whole Body Vibration to modify the body composition of young, healthy women. In is a novel and important problem. However, the manuscript needs some improvements, which are listed below.
Detailed comments and suggestions:
- Abstract:
o there is no information what body composition parameters were taken into consideration;
ANSWER: The missing information have been added (lines 22-26).
o there is no information that the participants were randomised (there is such information on the CONSORT-type scheme in the later part of the manuscript);
ANSWER: By the term "randomisation" in Figure 1 we understand the random selection of participants in the experiment, all volunteers who met the inclusion and exclusion criteria participated in the study, as we mentioned in Study participants subsection. The information has been added to Abstract, as suggested.
o the term “abnormal body composition” is not precise enough and should be exchanged for a clearer one;
ANSWER: It has been changed (lines 12-13).
o “selected” in the description of the recruiting of the participants sounds as if they were consciously selected to take part in the study, which was not the case, based on the rest of the text; that should be corrected;
ANSWER: I have changed the word from “selected” to “formed” (line 28).
- Introduction:
o ll. 68-69 – the sentence is unclear and should be rewritten;
ANSWER: The lines were rewritten (lines 76-81).
o l. 79 – the issue of safety is mentioned here; however, there is no mention of it in the aim of the study; additionally, no safety aspects are mentioned in the “Results” section, besides one sentence stating that no negative effects of vibration therapy were reported;
ANSWER: This was not the aim of the experiment, and we mention it only to explain why young and healthy women with normal body composition participated in the study, and why we treated the experiment as a preliminary studies. And as we mention it in Introduction section, and then no negative effects of vibration therapy were reported, we stated that in Results section as one sentence.
o ll.81-86 – the text should be moved to “Material and methods” section of the text, particularly, to the description of the study group;
ANSWER: It has been moved to “Material and methods” (lines 95-100).
o the numbering of the subsequent parts of “Material and methods” should be corrected;
ANSWER: It has been corrected.
- Material and methods:
o Study design:
- the first line of the text repeats the information from the previous part of the text; it should be removed from the “Introduction” and only left in this part of the manuscript;
ANSWER: It has been removed from “Introduction” section.
- the information that the “…overall number of participants was random, and so the C and V group selection…” is not clear and should be rewritten; there is also a part of the sentence missing (maybe it should be “and so WAS the C and V group selection”?); do the Authors mean that the study groups were not equally distributed to during the randomisation process? The same sentence is then repeated in line 118;
- the reasons for losing the participants from the study should be listed on the CONSORT-type graph;
ANSWER: The indicated sentences have been rewritten, the description of the unfinished study protocol has been added and the number of people in group V and C as in the CONSORT-type graph has been corrected
o Study participants:
- the description of the sample size is very chaotic and differs from one part of the text to another; for instance, first, the Authors write that the inclusion into study groups happened randomly, then that there were 280 participants in each group, then that there were 240 in total, and then, in lines 127-129, it says that the control was selected analogously to the 140 persons in the study group; then, the CONSORT-type graph represents one more version of the number of individuals in the study;
ANSWER: The corrections have been made.
- were the exclusion criteria formatted as bullet points? This part of the text should be formatted properly and/or rewritten;
ANSWER: The inclusion and exclusion criteria were rewritten as bullet points.
- the Authors state that “Volunteers who met all inclusion and exclusion criteria…”; if the participants met any of the exclusion criteria, they should be excluded from the study – the sentence should be corrected accordingly;
ANSWER: The sentence has been corrected.
- detailed reasons for losing the study participants should be provided in the text;
ANSWER: It has been supplemented.
- the characteristics of the study group together with the description of the study flow (participants lost from the study etc.) should be presented in the “Results”, not “Material an methods”;
ANSWER: The characteristics of the study group has been moved to the Results section.
o Body Composition Analysis:
- the description of the principle of estimating the amount of tissues by BIA is very simplified, and thus not completely correct;
ANSWER: The description has been corrected (lines 159-169).
- there is no information regarding the tools used for measuring the height and weight of the participants; additionally, the accuracy of the measurements, as well as the method (Martin, IBP etc.) should be provided;
ANSWER: The information have been provided as possible (171-173).
o Statistical Analysis:
- the precise type of ANOVA used for the analysis should be provided in the text;
ANSWER: Added in the Statistical analysis subsection
"Analysis of variance for repeated measurements, parameterization with sigma-constraints, decomposition of effective hypotheses".
- Results:
o it will be beneficial to provide total body fat in the table containing the basic characteristics of the sample;
ANSWER: It has been added.
o the descriptions below the tables should end with a period, not a coma;
ANSWER: It has been corrected.
o it will be helpful to present differences (baseline vs the last follow-up) in tables 2, 4 and 6;
ANSWER: The Before-After average differences have been added.
o Table 2 – there is no sufficient information on the p-value; what is the difference that it indicates (within groups, between groups etc?)?
ANSWER: p-values for data from Table 2 are collected in Table 3
o the description of the body water parameters is connected to the description of Table 6;
ANSWER: The description of Table 6 has been corrected.
- Discussion:
o a person first language should be used throughout the text
ANSWER: The Discussion section has been rewritten according to “person first” language.
Author Response File: Author Response.docx
Reviewer 4 Report
Dear authors. Some scores made in the first review were not inserted into the text. I consider them to be relevant additions, and so I present again in this review:
- line 96: Study participants: What intervention was made for the control group? (you need to inform).
- line 161-171: The sample calculation needs to be informed and referenced by some similar study.
- Legend of the Table 1, 3, 4, 5, 6 and 7: Must to report the level of significance established (adopted in this sutdy).
Author Response
Agata Lebiedowska, Ph.D. Sosnowiec, May 16th, 2023
Department of Basic Biomedical Science,
Faculty of Pharmaceutical Sciences in Sosnowiec,
Medical University of Silesia in Katowice, Poland
Dear Reviewer,
I am very grateful for the valuable opinions and remarks. I agree with all the comments and I have referred to them as best as possible:
Dear authors. Some scores made in the first review were not inserted into the text. I consider them to be relevant additions, and so I present again in this review:
- line 96: Study participants: What intervention was made for the control group? (you need to inform).
ANSWER: The additional information about control group has been added (lines: 104-107).
“In the control C group the volunteers had a BC measurement before and then after 6 weeks, no intervention was performed between the BC measurements. The participants were informed not to change their current lifestyle, i.e. a change in diet or physical activity in the period of time between BC measurements.”
- line 161-171: The sample calculation needs to be informed and referenced by some similar study.
ANSWER: Unfortunately, we had not calculate the sample before designing the study. The number of volunteers was dictated by practical conditions. After the research had been announced, 280 people volunteered. Thank you for reminding me about the sample calculation procedure. When designing further research, we will certainly perform it to increase the scientific value of the project.
- Legend of the Table 1, 3, 4, 5, 6 and 7: Must to report the level of significance established (adopted in this study).
ANSWER: Due to the large amount of data, the results have been organized in such a way that Tables 2, 4 and 6 contain descriptive statistics, while the results of tasting statistical hypothesis are placed in separate Tables 3, 5 and 7, just below the descriptive statistics. Table 1 contains both descriptive statistics and hypothesis testing results. Information about the level of significance (p<0.05) has been added to all tables containing data from hypothesis testing (Table 1, 3, 5, 7).
Author Response File: Author Response.docx
Round 2
Reviewer 3 Report
Thank you, the changes that have been made are satisfactory and have certainly improved the manuscript. I have no further comments.
Author Response
Dear Reviewer,
Thank you very much for your positive review and helpful cooperation.
Kind Regards,
Agata Lebiedowska
Reviewer 4 Report
Congratulations on the current form. They did a great paper.
