Electromyographic analysis of stomatognathic muscles in elderly after hippotherapy

Edneia Corrêa de Mello; Simone Cecílio Hallak Regalo; Luanna Honorato Diniz; Janaine Brandão Lage; Mariane Fernandes Ribeiro; Domingos Emanuel Bevilacqua Junior; Rodrigo César Rosa; Alex Abadio Ferreira; Mara Lúcia Fonseca Ferraz; Vicente de Paula Antunes Teixeira; Ana Paula Espindula

doi:10.1371/journal.pone.0238036

Peer Review History

Original SubmissionMarch 18, 2020
8 May 2020 Decision Letter - Thomas A Stoffregen, Editor PONE-D-20-07826 Analysis of the stomatognathic system in elderly individuals after hippotherapy PLOS ONE Dear Mrs de Mello, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please respond to the comments from each Reviewer. I agree with Reviewer 2 that a change in title is appropriate. A better title might be, "Electromyographic analysis of stomatognathic muscles in elderly individuals after hippotherapy". Separately, I feel it is imperative that you address, in your revised manuscript, some issues relating to your inferential statistics. In particular, please address the issue of multiple comparisons. In analyzing your results, you conducted many t-tests; at least 20. Did you make any correction for multiple comparisons, for example, in your criterion alpha? The submitted manuscript appears to suggest that you did not make such corrections. With appropriate correction for multiple comparisons, it is not clear that any of your effects would meet the criteria for statistical significance. We would appreciate receiving your revised manuscript by Jun 21 2020 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'. Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out. We look forward to receiving your revised manuscript. Kind regards, Thomas A Stoffregen, PhD Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Please include your tables as part of your main manuscript and remove the individual files. Please note that supplementary tables should be uploaded as separate "supporting information" files. 3. Thank you for stating the following in the Acknowledgments Section of your manuscript: "The authors are grateful for the financial support received for this research, provided by the following institutions: National Council for Scientific and Technological Development (CNPq), Coordination of Improvement of Higher-Level Personnel (CAPES), Foundation for Research Support of the State of Minas Gerais (FAPEMIG), Uberaba Teaching and Research Foundation (FUNEPU) and Association of Parents and Friends of the Exceptional of Uberaba (APAE)." We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: "No" Please clarify the sources of funding (financial or material support) for your study. List the grants or organizations that supported your study, including funding received from your institution. State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.” If any authors received a salary from any of your funders, please state which authors and which funders. If you did not receive any funding for this study, please state: “The authors received no specific funding for this work.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Manuscript ID: PONE-D-20-07826 “Analysis of the stomatognathic system in elderly individuals after hippotherapy” Level of interest: I have revised this manuscript, this interesting article should be accepted for publication. Quality of written English: Well done Statistical review: Right Declaration of competing interests: I have no competing interests to declare, hold no shares. “Analysis of the stomatognathic system in elderly individuals after hippotherapy” The authors state that the aim of the submitted manuscript was to identify how hippotherapy may alter the myoelectric activity of the masticatory muscles in elderly participants. This is an interesting and worthwhile observational, descriptive and quantitative research. Authors have put in a good effort on the project. Moreover, the research in my opinion is well written. There are several details that could be improved on this manuscript. Overall organization of the manuscript is good but further improvements in this area will significantly improve clarity of the paper. It is striking that the Method section is on page 11. The results are found on page 4 of this paper. Does not agree with the guidelines of the magazine. Please check it. Thank you In addition to this, I include minor reorganization of a few parts of the manuscript, and significant rewriting of certain sections as suggested below: 1) INTRODUCTION: Line 68 to 71 on page 3: Please could you add the following reference in these lines? Martín-Valero, R., Vega-Ballón, J., & Perez-Cabezas, V. (2018). Benefits of hippotherapy in children with cerebral palsy: A narrative review. European Journal of Paediatric Neurology, 22(6), 1150–1160. http://doi.org/10.1016/j.ejpn.2018.07.002 It is necessary to highlight the previously published results that found an increase in trunk strength and balance control. Hippotherapy is a treatment strategy that utilises equine movement as part of a comprehensive programme of intervention for the attainment of functional outcomes. It has been demonstrated tha the recreational use of therapeutic riding can improve coordination, motor skills, posture and control of the head. 2) Line 74 to 79 on Page 4. Please, I would recommend you that you can rewrtite these phrases. MATERIAL AND METHODS: 3) Is the study registered in clinical trials with a reference number? Please, would you mind adding the reference number, Thank you in advance. 4) Line 120 to 125 on page 5 and 6 : Please could you add any reference in these lines? 5) Rephrasing is needed in the following area to enhance clarity: Line 127 to 141 on page 6, please, could you improve the wording in these lines? Please could you add any reference in these lines? 6) DISCUSSION: Line 235 to 242 on Page 10. Please, I would recommend you that you can rewrtite these phrases. 7) CONCLUSION: Line 260 to 262 on Page 11. Please, I would recommend you that you can rewrtite these phrases. Reviewer #2: Dear authors, This is an interesting article related the use of hyppotherapy and EMG for the sthomarognathic system. I find the introduction section adequate and the aim of the study is correctly reported. Material and methods section explain clearly the study protocol used Results section shows the data obtained in the study and they are correctly explained in the discussion section. References appears adequate. I would like to suggest a modification in the title, in order that the readers can understand that this study is made with EMG. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0238036.r001
Revision 1
19 Jun 2020 Author Response Dear Professor Thomas A Stoffregen, We were pleased to have an opportunity to revise our manuscript entitled "Electromyographic analysis of stomatognathic muscles in elderly individuals after hippotherapy." In the revised manuscript, we have carefully considered the editors' and reviewers' suggestions, and we adjusted some paragraphs accordingly. Below are the points we address and respond to each point raised by the editor and the reviewer. The responses to the editor's and reviewer's comments are below and are color-coded as follows: a) Comments from editors or reviewers are colored in red b) Our responses are shown under each comment as standard text. Overall, the comments were constructive, and we are appreciative of such constructive feedback on our original submission. After addressing the issues raised, we feel the quality of the paper is much improved. Best regards, Edneia Corrêa de Mello Responses to editors’ comments: In analyzing your results, you conducted many t-tests; at least 20. Did you make any correction for multiple comparisons, for example, in your criterion alpha? The submitted manuscript appears to suggest that you did not make such corrections. With appropriate correction for multiple comparisons, it is not clear that any of your effects would meet the criteria for statistical significance. To avoid the type I error, common when many t-tests are conducted; we opted for Repeated Measured ANOVA with Bonferroni’s post hoc. We also chose to work with the electromyography data because much information is lost when normalizing the data (lines 152 - 161, on page 7). 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf On the title page, we added the department and listed the corresponding author's initials in parentheses after the email address. We adjusted the names of the files. We hope that it now fits the style requirements, as described in the referred templates. 2. Please include your tables as part of your main manuscript and remove the individual files. Please note that supplementary tables should be uploaded as separate "supporting information" files. We included our tables as part of the main manuscript and removed the individual files. 3. Thank you for stating the following in the Acknowledgments Section of your manuscript: "The authors are grateful for the financial support received for this research, provided by the following institutions: National Council for Scientific and Technological Development (CNPq), Coordination of Improvement of Higher-Level Personnel (CAPES), Foundation for Research Support of the State of Minas Gerais (FAPEMIG), Uberaba Teaching and Research Foundation (FUNEPU) and Association of Parents and Friends of the Exceptional of Uberaba (APAE)." We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: "No" a. Please clarify the sources of funding (financial or material support) for your study. List the grants or organizations that supported your study, including funding received from your institution. b. State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.” c. If any authors received a salary from any of your funders, please state which authors and which funders. d. If you did not receive any funding for this study, please state: “The authors received no specific funding for this work.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf We removed all funding-related text from the manuscript and would like to keep our Funding Statement as we wrote in our Cover Letter. Responses to reviewer #1: There are several details that could be improved on this manuscript. Overall organization of the manuscript is good but further improvements in this area will significantly improve clarity of the paper. It is striking that the Method section is on page 11. The results are found on page 4 of this paper. Does not agree with the guidelines of the magazine. Please check it. Thank you. The Method section on page 11 was removed from this paper. “Non-habitual chewing is a standardized short-opening, flap-type, mouth-to-mouth movement required to reduce the effects of changing length and muscle tension typical of dynamic records. Thus, it eliminates some interference factors that act in chewing, such as swallowing between masticatory cycles, chewing frequency, food texture, and masticatory preference.” The results found on page 4 were transferred to the Results section (lines 164 - 171, on page 6 and 7). In addition to this, I include minor reorganization of a few parts of the manuscript, and significant rewriting of certain sections as suggested below: 1) INTRODUCTION: Line 68 to 71 on page 3: Please could you add the following reference in these lines? Martín-Valero, R., Vega-Ballón, J., & Perez-Cabezas, V. (2018). Benefits of hippotherapy in children with cerebral palsy: A narrative review. European Journal of Paediatric Neurology, 22(6), 1150–1160. http://doi.org/10.1016/j.ejpn.2018.07.002 It is necessary to highlight the previously published results that found an increase in trunk strength and balance control. Hippotherapy is a treatment strategy that utilizes equine movement as part of a comprehensive program of intervention for the attainment of functional outcomes. It has been demonstrated that the recreational use of therapeutic riding can improve coordination, motor skills, posture and control of the head. Thank you for the indication, we rewrote this paragraph and added the reference [13] (lines 61 – 71, on page 3). 2) Line 74 to 79 on Page 4. Please, I would recommend you that you can rewrite these phrases. We rewrote these phrases (lines 74 – 78, on page 4). MATERIAL AND METHODS: 3) Is the study registered in clinical trials with a reference number? Please, would you mind adding the reference number, Thank you in advance. The study registered in clinical trials with this reference number RBR-2kw6p9, and access is found on this link (http://www.ensaiosclinicos.gov.br/rg/?q=RBR-2kw6p9) (lines 86 and 87, on page 4). 4) Line 120 to 125 on page 5 and 6: Please could you add any reference in these lines? We added references on these lines [17,18] [19] (lines 116 and 117, on page 5). 5) Rephrasing is needed in the following area to enhance clarity: Line 127 to 141 on page 6, please, could you improve the wording in these lines? Please could you add any reference in these lines? We rewrote this paragraph and added references [21] [22] (lines 119 - 136, on page 6 and 7). 6) DISCUSSION: Line 235 to 242 on Page 10. Please, I would recommend you that you can rewrite these phrases. We rewrote this paragraph (lines 250 - 255, on page 12). 7) CONCLUSION: Line 260 to 262 on Page 11. Please, I would recommend you that you can rewrite these phrases. We rewrote this paragraph (lines 270 and 271, on page 13). Responses to reviewer #2: I would like to suggest a modification in the title, in order that the readers can understand that this study is made with EMG. We modified the title: Electromyographic analysis of stomatognathic muscles in elderly after hippotherapy Thank you again for your time and effort, Best regards Edneia Mello Attachments Attachment Submitted filename: Rebuttal Letter.docx https://doi.org/10.1371/journal.pone.0238036.r002
24 Jun 2020 Decision Letter - Thomas A Stoffregen, Editor PONE-D-20-07826R1 Electromyographic analysis of stomatognathic muscles in elderly after hippotherapy PLOS ONE Dear Dr. de Mello, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. I have noted elsewhere details about requested revisions. Please submit your revised manuscript by Aug 08 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Thomas A Stoffregen, PhD Academic Editor PLOS ONE Additional Editor Comments (if provided): Thank you for your careful revisions. Please note additional requests from Reviewer 1. As Editor, I continue to feel the need for more information about your statistical analysis. In the Section on Statistical Analysis (Line 156 FF), please state explicitly the factors in your ANOVAs. In addition, please revise Tables 1 and 2 to include the F values and degrees of freedom associated with each p-value. Once these matters are cleared up, your manuscript should be ready for publication. [Note: HTML markup is below. Please do not edit.] [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0238036.r003
Revision 2
5 Aug 2020 Author Response We added more information about our statistical analysis. We explain the factors of the ANOVAs In the Section on Statistical Analysis. We have also included the F values and degrees of freedom associated with each p-value in Tables 1 and 2. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0238036.r004
10 Aug 2020 Decision Letter - Thomas A Stoffregen, Editor Electromyographic analysis of stomatognathic muscles in elderly after hippotherapy PONE-D-20-07826R2 Dear Dr. de Mello, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Thomas A Stoffregen, PhD Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0238036.r005
Formally Accepted
12 Aug 2020 Acceptance Letter - Thomas A Stoffregen, Editor PONE-D-20-07826R2 Electromyographic analysis of stomatognathic muscles in elderly after hippotherapy Dear Dr. de Mello: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Thomas A Stoffregen Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0238036.r006

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