PONE-D-23-03014Effects of joint mobilization combined with acupuncture on pain, physical function, and depression in stroke patients with chronic neuropathic pain: a randomized controlled trialPLOS ONE

Dear Dr. Lee,

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.

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ACADEMIC EDITOR:As a scientific study of acupuncture and moxibustion, the most fatal problem in this paper is, as pointed out by reviewer 2, that acupuncture and moxibustion MUST provide consistent basic acupoints, and show and write the name and location of the acupoints, e.g. based on "WHO Standard Acupuncture Point Locations ( https://apps.who.int/iris/handle/10665/353407)". Also, if possible, the authors could provide specific images and videos of joint mobilization techniques.

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Tadashi Kobayashi, M.D., Ph.D

Academic Editor

PLOS ONE

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Additional Editor Comments:

As a scientific study of acupuncture and moxibustion, the most fatal problem in this paper is, as pointed out by reviewer 2, that acupuncture and moxibustion MUST provide consistent basic acupoints, and show and write the name and location of the acupoints, e.g.　based on "WHO Standard Acupuncture Point Locations ( https://apps.who.int/iris/handle/10665/353407)". Also, if possible, the authors could provide specific images and videos of joint mobilization techniques.

[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: No

Reviewer #3: Yes

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

Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: 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

Reviewer #3: 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

Reviewer #3: 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: This manuscript reports the results of a study in post-stroke patients of two competing treatments and a control treatment. The manuscript is generally well-written and the study appears to be well-performed.

Line 49: Change to "post-stroke".

Line 210: Delete "statistically".

Please provide more detail on the methodology used to perform the two-way analysis with repeated measures. Was this implemented within the linear mixed model framework? If so please describe the model in terms of fixed effects, G-side terms, and R-side terms (if any). Or was this implemented within the older framework using Greenhouse-Geisser or Huynh-Feldt correction? If so please describe the methodology used to assess sphericity. Or was this implemented using the older framework using a multivariate analysis of variance? If so, please describe the tests used.

Line 228: For this and other tables, please provide the analysis of variance p-values for the terms in the model --- or at least consider providing these as supplementary information. Please footnote the table to provide the statistical tests or multiple comparison methods used.

Note that pairwise comparison methods that control the experimentwise error rate may be used regardless of the analysis of variance results. However, it is best to assess the data for interaction effects before assuming the main effects structure.

Line 235: Change "between" to "among". Or clarify that this "between" refers to pairwise comparisons.

Line 314: Change to "The majority... were older farmers...".

Reviewer #2: 1. In my opinion, a reasonable randomized controlled trial should provide a formula for calculating sample size, but this paper does not2. Personally, I think acupuncture and moxibustion should provide consistent basic acupoints. This paper does not clearly give the name and location of the acupoints taken

Reviewer #3: Abstract: To investigate....(AC) for THE treatment OF pain, ... (missing words)

Introduction line 44 "Stroke is one of (how many? what percentage)?

This sentence is confusing (line 73): "The convex-concave rule states that gliding on a convex joint surface should be done the opposite way the bone moves, and gliding on a concave joint surface should be done the opposite way." Not sure why both state "opposite way."

Reference for line 80?

Table 1: the JM+AC group were younger, with less time since onset. Although not a significant p value, these differences need to be addressed.

Line 150: Was there standard acupuncture points used? Or was the AC treatment individualized?

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: Yes: Jennifer E Brett

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Effects of joint mobilization combined with acupuncture on pain, physical function, and depression in stroke patients with chronic neuropathic pain: a randomized controlled trial

PONE-D-23-03014R1

Dear Dr. Lee,

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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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,

Tadashi Kobayashi, M.D., Ph.D

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

The authors have amended adequately.

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 #1: All comments have been addressed

Reviewer #2: All comments have been addressed

Reviewer #3: 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 #1: (No Response)

Reviewer #2: (No Response)

Reviewer #3: Yes

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

Reviewer #1: (No Response)

Reviewer #2: (No Response)

Reviewer #3: Yes

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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 #1: (No Response)

Reviewer #2: (No Response)

Reviewer #3: Yes

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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 #1: (No Response)

Reviewer #2: (No Response)

Reviewer #3: Yes

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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 #1: (No Response)

Reviewer #2: (No Response)

Reviewer #3: (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 #1: No

Reviewer #2: No

Reviewer #3: No

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