Abstract:Introduction This study aims to observe the differences between adolescents with and without Down syndrome (DS) in the effects of 20 weeks of whole-body vibration (WBV) training, on bone mineal content (BMC), and density (BMD). Methods 26 adolescents (13 DS;(12)(13)(14)(15)(16)(17)(18) were measured with dual-energy x-ray absorptiometry before and after the intervention (3/week, 10 repetitions (30-60 seconds) and 1-min rest, frequency 25-30 Hz, and peak-to-peak displacement of 2 mm (peak acceleration 2.5-3.6 g)). Both, an intention-to-treat (ITT) analysis designed to assess the effects on bone mass, and a per-protocol analysis, designed to compare poor-and high-compliers, were performed. Results The ITT analysis revealed significant increases in all BMC and BMD parameters (dz = 0.66 to 1.64; all p<0.05) in the non-DS group, whilst DS group improved whole-body, subtotal (whole-body less head), upper limbs (ULIMBS), pelvis, lower limbs (LLIMBS) and spine BMC (dz = 0.75 to 1.76; all p<0.05) and subtotal, pelvis, LLIMBS, and spine BMD (dz = 0.73 to 1.28; all p<0.05). Significantly greater increases were evident in the absolute and percent changes of the non-DS group over DS group (d = 0.88 to 3.85; all p<0.05). ULIMBS BMD showed a tendency towards an interaction (f = 0.41 and p = 0.086) with higher increase for non-DS group. When a per-protocol analysis was considered, high-complier adolescents had 8.1 versus 5. Dear Editor, Please, find attached a revised version of our manuscript entitled "Effect of whole-body vibration training on bone mass in adolescents with and without Down syndrome: a randomized controlled trial" to be reconsidered for publication in your prestigious journal.We have taken into account all the comments made from the reviewer and a point-bypoint response has been attached to our submission. In addition, we have highlighted in yellow the pertinent changes in the main manuscript for an easier revision. This manuscript represents original unpublished material; is not under consideration for publication elsewhere, and further, it will not be submitted for publication elsewhere until a decision is made regarding its acceptability for publication in your Journal. The manuscript presented by Matute-Llorente and colleagues is clearly of interest to people working in all health related disciplines. The manuscript provides an interesting argument in the understanding of the relationship between Down syndrome changes in bone mass after vibration training. The structure of the document is well written and follows an appropriate structure that makes for an easy, detailed and informative read. Response: Thank you very much for your revision of our manuscript. All your comments have been addressed and explained below. Also, the changes have been highlighted in yellow in the manuscript in order to make easier the revision process.
MINOR CONCERNS:P4L49 how will gender impact the changes in BMD between these two groups? R: Thanks for your comment, we have realised the excessive length and lack of clarit...