FROM : REPAIR-EDS: Rehabilitation Enhanced by Partial Arterial Inflow Restriction (REPAIR) in Eheler-Danlos Syndrome (EDS) Patients

• Article Title: Repair EDS: rehabilitation enhanced by partial arterial inflow restriction in Ehlers Danlos Syndrome patients

   

  Reviewer’s 1 & 2 comments:

   

  • The manuscript provides and offers valuable insight into alternative rehabilitation approaches for patients with Ehlers Danlos Syndrome. The findings suggest promising avenues of continued exploration in rehabilitation strategies.

  Thank you for the comments.

  • Ensure to spell Ehlers Danlos Syndrome correctly otherwise suitable

  Corrected.

  • Introduction and background is well written.

  Thank you.

  • Methods- list what types of EDS where used in this study. Did you find one more than another? Is that accounted for in statistics? Outcome measures - did the hand held dynamometer account for human error? List in statistics.

  All Added to the Method.

  • For the ultrasound, why did you use the gastrocnemius? Is there a specific protocol or SOP used to ensure consistence? The person or group performing the ultrasound, were they standardized? What was the power of this study? Can you add into the statistics.

  Gastrocnemius measurements were taken to investigate potential distal benefits. All ultrasound measurements were performed by the same researcher to enhance reliability [50].

  Statistical Analysis

  To analyze muscle strength and volume 2×5 repeated measures ANOVAs with a between subject variable identified as Group (Experimental=PT-BFR vs. Control=PT) and a within subject variable identified as Time (Baseline, 3-, 6-, 9-, and 12-months). A 2×5 repeated measure ANOVA was used to assess the self-reported outcome measures PHQ-9 and WHOQOL-Bref scores for domains 1-4. Significant effects were explored using pairwise contrasts with Bonferroni corrections. Statistical significance was set as at p < .05.

  To verify the normality of data distribution, the Shapiro-Wilk test was employed, confirming that all variables met this assumption. The Mauchly's sphericity test assessed the sphericity assumption for repeated measures ANOVAs, and Greenhouse-Geisser corrections were applied to factors violating this assumption. The Levene's test ensured homogeneity of variance among the sample data, with all data satisfying this criterion. A threshold for statistical significance was established at p < 0.05. All statistical analyses were conducted using Statistica (version 13, Dell Inc.). Results are presented as estimated marginal means. A power calculation was not performed prior due to this being a proof-of-concept pilot study.

   

  into the statistics.