PONE-D-20-03903

Perspectives of wheelchair users with spinal cord injury on fall circumstances and fall prevention: a mixed methods approach using photovoice

PLOS ONE

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Yih-Kuen Jan, PhD

Academic Editor

PLOS ONE

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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

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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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

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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

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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: I thank the editor for allowing me to rate this article.

The value is well conducted and well detailed in all its points. It has a strong and precise methodological structure.

the evaluation of aids in patients with spinal cord injury is very important, but this work certainly makes a good contribution to the scientific literature

I therefore request that the article be accepted in its current form without modification.

Reviewer #2: Thank you for the opportunity to review your manuscript entitled “Perspectives of wheelchair users with spinal cord injury on fall circumstances and fall prevention: a mixed methods approach using photovoice”. The manuscript is clear, very well written, the topic would be of interest of readers, the manuscript would also contribute to develop ‘effective’ fall prevention programs among wheelchair users with SCI and improve the quality of care in this population. I have highlighted some points that I believe would improve the quality of the manuscript.

Reference 13 is not under review anymore. Please update this!

Figure 1 and line 153: 1-year fall tracking has shown a higher frequency of fall among wheelchair users with SCI. It is not clear why the authors decided a 6-month fall tracking? Please provide a justification.

Line 137: Were wheelchair athletes included? For example: a fall during a wheelchair basketball game is different from a fall which results from a wheelchair to bed fall. This needs to be addressed. During a wheelchair basketball game, a wheelchair user can fall 5 or more times. Did you ask participant to count those falls in this study?

Line 160: 3 to 4 weeks before reminding participants to complete the fall survey seems a lot and the fall recording might be not that accurate (generally 2 weeks is used). This should be addressed in the limitations of the study.

Line 229: The difference is just significant, a priori; this is almost p = 0.05

Table 2: A better description is needed for falls from sports/exercise.

I suggest also exploring the relationship between recurrent falls (more than 1 and report of injuries). This might consolidate the existing literature.

It is surprising that ‘Environment’ was not found as a subtheme since slippery surface, cluttered space, etc. have been frequently reported as fall risk factors as well among wheelchair users with SCI. This does not necessarily need to be in the community but at home.

I was expecting to see any specificity for manual wheelchair users vs power wheelchair users in terms of fall circumstances and fall prevention recommendations (even though your sample presented with few power wheelchair users). This could provide some information for future research.

Lines 597 – 601: Another explanation might be the difference in risk management; women tend to take less risk than men and might avoid going through uneven surfaces. This could definitely limit them to do some activities.

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Reviewer #1: No

Reviewer #2: No

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Perspectives of wheelchair users with spinal cord injury on fall circumstances and fall prevention: a mixed methods approach using photovoice

PONE-D-20-03903R1

Dear Dr. Musselman,

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.

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Kind regards,

Yih-Kuen Jan, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. 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 #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. 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 #2: (No Response)

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5. 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 #2: Yes

**********

6. 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 #2: (No Response)

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7. 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 #2: No