PONE-D-23-32900Perceptions, behaviours and barriers towards exercise practices in inflammatory bowel diseasePLOS ONE

Dear Dr. Bottoms,

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.

While the general tone of the reviews is positive, some concerns have been raised. I would invite the authors to submit a major revision to address them. Some of the points to keep in mind are: 

1. Shorten and edit the introduction to reduce redundancy and enhance clarity;

2. Include additional information about the studied population;

3. Emphasize the novelty of the study in the discussion section;

4. Elaborate on the concept of "combination factors" and specify which factors mainly contributed to the avoidance of exercise.

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Satyaki Roy, Ph.D.

Academic Editor

PLOS ONE

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Additional Editor Comments:

While the general tone of the reviews is positive, some concerns have been raised. I would invite the authors to submit a major revision to address them. Some of the points to keep in mind are as follows:

1. Shorten and edit the introduction to reduce redundancy and enhance clarity;

2. Include additional information about the studied population;

3. Emphasize the novelty of the study in the discussion section;

4. Elaborate on the concept of "combination factors" and specify which factors mainly contributed to the avoidance of exercise.

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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: Partly

Reviewer #3: Partly

Reviewer #4: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: 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

Reviewer #4: 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

Reviewer #4: 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: The paper is about a survey, conducted among Inflammatory Bowel Disease patients in UK, concerning perceptions, behavior and barriers towards physical exercise. The argument is interesting and the study population is consistent, although with unusual great prevalence of female patients. The study results are clearly described and discussed.

However, more information could be useful concerning the so called “disease burden” as it could affect the feasibility of physical exercise besides disease activity. Ideally, the description of the studied population should include the Montreal classification (including age of disease onset, disease location and, for Crohn’s disease, the disease behavior). I understand that given the recruitment method adopted for the research this information could not be easy to collect. At least the information about previous IBD surgeries (yes/no, and if yes how many time, is a stoma present?) could be usefully added. Other easy to collect information could be the BMI: alterations of nutritional status could also have influence on physical activity.

A further minor point: line 67, tofacitinib is not correctly classifiable as a biologic drug, best defined as “small molecule”.

Reviewer #2: There are some revisions inside the manuscript like corrections, reduce the introduction and others must do it.

Reviewer #3: I read with interest the paper by Sinclair et al entitled "Perceptions, behaviours and barriers towards exercise practices in inflammatory bowel disease". It is an observational survey based on a self-admnistered, online questionnaire specifically desisgned for the purpose of the study and the enrollment was fully on social media.

In my opinion the paper is well written although different limitations are present (introduction is too long and editable, baseline characteristics of the included population are scant - for example concomitant extraintetsinal manifestations, other comorbidites ecc; I would have preferred a more detailed discussion recalling availble literature)

My fear is the lack of novelty associated to this paper where a plenty of literature is present (and in teh discussion the real novelty is not highlighted)

Reviewer #4: 1. The introduction should be shorter because of its redundancy.

2. The readers need help understanding the meaning of another IBD condition. Please give more detailed information.

3. What exactly are combination factors? Please describe in detail. Additionally, what combination of factors mainly contributed to the avoidance of exercise?

4. What are the sources of information on patients who think aerobic exercise is beneficial for IBD disease control?

5. Are there differences in response to the questions listed in Table 3 by age, between patients not on drug therapy and those who are, and between patients receiving biological therapy and those not receiving it?

6. Most IBD patients seem to know little about the significance of resistance training. Why is this? Are these perceptions different by age?

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Reviewer #1: No

Reviewer #2: Yes: Prof. Dr. Neihaya Heikmat Zaki

Reviewer #3: No

Reviewer #4: No

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Attachments

Attachment

Submitted filename: PLOS_ONE_SUBMIT.docx

Perceptions, behaviours and barriers towards exercise practices in inflammatory bowel disease

PONE-D-23-32900R1

Dear Dr. Bottoms,

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,

Satyaki Roy, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

The authors have addressed all concerns. I recommend accepting the manuscript.

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 #3: All comments have been addressed

Reviewer #4: 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: Yes

Reviewer #3: Yes

Reviewer #4: Yes

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

Reviewer #1: Yes

Reviewer #3: Yes

Reviewer #4: 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 #1: Yes

Reviewer #3: Yes

Reviewer #4: 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: Yes

Reviewer #3: Yes

Reviewer #4: (No Response)

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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: The Authors’ answers to the reviewers’ comments are sufficient. The modifications to the manuscript make it suitable for publication.

Reviewer #3: Dear Authors,

thank you for your reply and the effort.

I think you have fully answered to all the comments

Reviewer #4: The authors appropriately responded to this reviewer's comments.

Unfortunately, the authors should accumulate more information of IBD patients in this study.

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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 #3: Yes: Stefano Festa

Reviewer #4: No

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