Neurophysiological Evaluation of the Functional State of Muscular and Nervous Systems in High-Maneuvering Jet Fighters

Round 1

Reviewer 1 Report

I am quite ready to acknowledge that this study is original and is the first to apply a set of diagnostic neurophysiological methods in the clinical evaluation of the jet fighters' health status as stated. However, in the course of reading this MS, I had a few questions about the research methodology, as well as the interpretation of the reported results.

Major concerns/ questions

Results

The age, weight of pilots and healthy volunteers varied by 2 times, and the number of hours for pilots from 410 to 3100, that is within 7-8 times. This seems to me to be a larger spread. Did the authors consider measuring the correlation between the pilots' response parameters and the values of their age, weight and, especially, the number of hours of flight ? This approach seems to me quite worthy of attention. If not, then please explain why?.

Lines 265-269 и 271-278. In two paragraphs, the authors talk about significant differences and indicate that p was= 0.05. In table 3, as I understand it, differences with p=0.05  (at least 7 cases) are considered significant. This is not clear to me. I used to think that p value of 0.05 means that the differences are not significant, or at leas at the level of significance. I think the authors need at least to explain why the test results for p=0.05 are considered significant.

Minor

Methods

Page 5. 173-177. How often was this classification system used? Why modified and how?. I would recommend referencing to some other publications at least..

Page 5. Was EP recorded in response to each electrical stimulation with a frequency of 1 Hz, or was the response cumulative, to a certain number of simulations?...

Line 191 and after... The same question applies to the study of efferent transmission. Do you mean individual responses (EP) to each simulation or cumulative responses to a number of stimuli.

Page 5, Line 204.

I would recommend including some details how von Frey's filaments were used in these studies and how the results were processed.

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

Dear authors,

I would like to express my gratitude regarding the opportunity to review this manuscript.

At this stage the manuscript requires several improvements. Below suggestions with line indication:

 Line 227 In table 1 (Table 2 and 3 as well), replace the separator “,” with “.” and add parentheses when presenting a range.

Line 257 You wrote “The values of amplitudes of sEMG recordings during the attempt of maximal contraction (mcEMG) have been found to be significantly higher in all examined muscle groups in pilots at p=0,02-0,04, pointing to the better ability of the muscle motor units for the contractile properties than in controls”. If you have not measured force as a result of contraction, you cannot describe the effect as differences between pilots and control patients.

Line 231 What kind of activity or training you mean when writing “The pilots conducted moderate physical activity (training)”? Better describe this part. What kind of work did people in the control group do? Don't you think the pilots were fatter? How can this affect test results?

Line 234 On what kind of aircrafts pilots experienced 1711 hours of flying the high-maneuvering aircraft at 7G over-loading?

Line 247 Use the dot at the end of the line.

Line 309 You wrote “ Based on our research results, it can be assumed that high-maneuver fighter pilots develop moderate ailments in the lumbosacral rather than cervical spine, with symptoms corresponding to the consequences of disc-root conflicts of various etiopathogenesis diagnosed using clinical neurophysiology methods and described in other studies [14-19].” Aren't these results the result of group selection? Pilots are usually sedentary, so test subjects should be deliberately selected from a population that is also sedentary. Previous studies have shown that overload injuries of the cervical spine are a greater problem compared to the normal population than problems of the lumbar spine. Can you relate this to your results? Don't they seem contradictory?

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

The authors have addresses my questions and concerns, and edited the MS.