The effect of a telephone-based intervention on physical activity after stroke

Seungwoo Cha; Won Kee Chang; Hee-Mun Cho; Yun-Sun Jung; Miji Kang; Nam-Jong Paik; Won-Seok Kim

doi:10.1371/journal.pone.0276316

Peer Review History

Original SubmissionJune 21, 2022
14 Sep 2022 Decision Letter - Billy Morara Tsima, Editor PONE-D-22-17677The Effect of a Telephone-based Intervention on Physical Activity after StrokePLOS ONE Dear Dr. Kim, 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 submit your revised manuscript by Oct 29 2022 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: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Billy Morara Tsima, MD MSc 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 review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [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: １．Depression is evaluated by PHQ-9, but evaluation of comprehension and memory ability for telephone intervention may affect the results. Therefore, it is desirable to add the location of the lesion (cortical or subcortical) and the presence or absence of aphasia (especially the presence or absence of comprehension disorders) to the comparison of baseline characteristics. ２．It is unclear whether the band of the curve in Fig.3 shows a continuous change or a discontinuous change. The curve is shown as active to inactive after 1 month, active again after 2 months, and inactive again after 3 months. Is that interpretation correct? ３．It would be better to evaluate and analyze changes in the degree of PA (Health enhancing PA/Minimally active). ４．Although the purpose of this study is the effect of a telephone-based intervention on PA, it is desirable to consider the relationship between PA improvement and mRS improvement in the discussion. Reviewer #2: The authors present an important topic of nurse intervention and telephone monitoring of the health and physical activity of patients who have recently had a stroke. The authors rightly noted that physical activity provides benefits for health-related outcomes after stroke and cardiovascular risk factor management. Physical activity also supports social participation, helping stroke survivors to achieve their goals and adjust to life after stroke. Of course, telephone interventions limit the amount of information that can be gathered about a patient's current condition, but how previous studies have shown the feasibility and effectiveness of telephone-based interventions in patients after stroke. The study is designed well. The title and abstract cover the main aspect of the work. The introduction provides background and information relevant to the study. The methodology are described very exactly and clearly. The statistical analysis is performed correctly. The results are described accurately and clearly. The authors accurately described the limitations of the study. The manuscript is written correctly. The authors rightly conclude that further studies with a larger number of patients and long-term follow-up are needed. The weak points of the study are that there was the single-center study, hospital-based retrospective study and the sample size was small. ****** 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: Yes: Piotr Sobolewski ******** [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.0276316.r001
Revision 1
27 Sep 2022 Author Response #Comment 1-1 Depression is evaluated by PHQ-9, but evaluation of comprehension and memory ability for telephone intervention may affect the results. Therefore, it is desirable to add the location of the lesion (cortical or subcortical) and the presence or absence of aphasia (especially the presence or absence of comprehension disorders) to the comparison of baseline characteristics. Response: We thank the reviewer for this comment. Cortical involvement was determined after reviewing imaging findings. Aphasia was defined based on the NIHSS item 9 for best language during admission. In the fully adjusted model for the odds ratio of the intervention, the cortical involvement and aphasia were also adjusted. #Comment 1-2 It is unclear whether the band of the curve in Fig.3 shows a continuous change or a discontinuous change. The curve is shown as active to inactive after 1 month, active again after 2 months, and inactive again after 3 months. Is that interpretation correct? Response: We thank the reviewer for this comment. The level of physical activity was measured four times (at discharge and 1, 2, and 3 months after discharge). Fig. 3 (Sankey diagram) illustrates the changes in physical activity level between consecutive time points, which are discontinuous. Therefore, Fig. 3 was revised to reveal the discontinuity clearly, and the sentences about physical activity evaluation have been added. #Comment 1-3 It would be better to evaluate and analyze changes in the degree of PA (Health enhancing PA/Minimally active). Response: Thank you for your comment. Few patients displayed health-enhancing PA as illustrated in the revised Fig 3 (B) (Green = Health-enhancing PA, Orange = Minimally active, and Red = Inactive). The number of patients with health-enhancing PA was 7, 0, 2, and 6 at discharge, 1, 2, and 3 months after discharge, respectively. Therefore, it was challenging to analyze the clinical characteristics of those with health-enhancing PA separately. Instead, we revised Fig 3 to include changes in PA degree ((A): active and inactive, (B): health-enhancing physical activity, minimally active, and inactive). #Comment 1-4 Although the purpose of this study is the effect of a telephone-based intervention on PA, it is desirable to consider the relationship between PA improvement and mRS improvement in the discussion. Response: Thank you for your comment. Baseline mRS scores differed between the intervention and control groups; however, mRS score improvement within 3 months after discharge was not significantly different between both groups. In addition, mRS score improvement did not significantly differ based on PA changes in the intervention group (the analysis was conducted only in the intervention group because the PA level at discharge was not evaluated in the control group). This may suggest that PA improvement results from the intervention rather than PA improvement during stroke recovery. The table is presented as S4 Table. #Comment 2-1 The authors present an important topic of nurse intervention and telephone monitoring of the health and physical activity of patients who have recently had a stroke. The authors rightly noted that physical activity provides benefits for health-related outcomes after stroke and cardiovascular risk factor management. Physical activity also supports social participation, helping stroke survivors to achieve their goals and adjust to life after stroke. Of course, telephone interventions limit the amount of information that can be gathered about a patient's current condition, but how previous studies have shown the feasibility and effectiveness of telephone-based interventions in patients after stroke. The study is designed well. The title and abstract cover the main aspect of the work. The introduction provides background and information relevant to the study. The methodology are described very exactly and clearly. The statistical analysis is performed correctly. The results are described accurately and clearly. The authors accurately described the limitations of the study. Response: We thank the reviewer for this comment. We agree with the comment and believe that our study, consistent with previous studies, supports the telephone-based intervention on physical activity improvement in patients with stroke. Thank you. Attachments Attachment Submitted filename: Response to Reviewers_09.27.docx https://doi.org/10.1371/journal.pone.0276316.r002
5 Oct 2022 Decision Letter - Billy Morara Tsima, Editor The Effect of a Telephone-based Intervention on Physical Activity after Stroke PONE-D-22-17677R1 Dear Dr. Kim, 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, Billy Morara Tsima, MD MSc Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0276316.r003
Formally Accepted
13 Oct 2022 Acceptance Letter - Billy Morara Tsima, Editor PONE-D-22-17677R1 The Effect of a Telephone-based Intervention on Physical Activity after Stroke Dear Dr. Kim: 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. Billy Morara Tsima Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0276316.r004

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .