PONE-D-24-17855Rock Steady Boxing: A Qualitative Evaluation of a Community Exercise Program for People with Parkinson’s DiseasePLOS ONE

Dear Dr. Regan,

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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Based on the reviewers' suggestions, the paper needs major revision.  The reviewers' comments can be found below.

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Tanja Grubić Kezele, Ph.D., M.D.

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: N/A

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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: This study is about the qualitative evaluation of the Rock Steady Boxing (RSB) community exercise program for Parkinson's disease patients. I have the following suggestions:

1. In this study, semi-structured interviews and course observations were used, which are commonly used methods in qualitative research. Suggest the author to consider whether it is necessary to add quantitative data to support qualitative findings.

2. The study involved 10 participants, which is a relatively small sample size. Suggest the author to discuss the potential impact of sample size on research results and consider how to make the results more universal.

3. The results section should clearly present the research findings and compare them with existing literature and other studies. Suggest the author to consider adding comparative analysis to highlight the uniqueness and potential advantages of the RSB project.

5. The discussion section should delve into the meaning of research findings and how they relate to existing theories and practices. It is suggested that the author consider proposing specific practical suggestions and how to translate the research results into strategies to improve the quality of life of Parkinson's disease patients.

6. It is suggested that the author consider whether RSB can serve as an adjunct to the treatment of Parkinson's disease and discuss its potential applications in a wider community.

7. The references are too outdated.

Reviewer #2: This study provides valuable insights into the impact of the Rock Steady Boxing program on individuals with Parkinson’s Disease. Despite its strengths, including a well-defined qualitative approach and practical implications, the manuscript could be improved by addressing its limitations more thoroughly, integrating the qualitative and quantitative data more effectively, and providing clearer directions for future research.

Abstract

The abstract could benefit from a brief mention of the sample size and the duration of the study.

It should include the primary outcomes measured to give readers a quick insight into the key findings.

Introduction

The introduction is lengthy and could be more concise. Some background information could be summarized to maintain focus.

It would be helpful to include more recent references to ensure the literature review is up-to-date, such as:

Bevilacqua R, et al. Rehabilitation of older people with Parkinson's disease: an innovative protocol for RCT study to evaluate the potential of robotic-based technologies. BMC Neurol. 2020 May 13;20(1):186. doi: 10.1186/s12883-020-01759-4

Maranesi E, et al. The Effect of Non-Immersive Virtual Reality Exergames versus Traditional Physiotherapy in Parkinson's Disease Older Patients: Preliminary Results from a Randomized-Controlled Trial. Int J Environ Res Public Health. 2022 Nov 10;19(22):14818. doi: 10.3390/ijerph192214818

Mao Q, et al. Effectiveness of sensor-based interventions in improving gait and balance performance in older adults: systematic review and meta-analysis of randomized controlled trials. J Neuroeng Rehabil. 2024 May 28;21(1):85. doi: 10.1186/s12984-024-01375-0.

Material and methods

The sample size of ten participants is relatively small, which could limit the generalizability of the findings. The authors should acknowledge this limitation more explicitly.

The methodology section could benefit from a more detailed description of the interview and observation protocols to enhance reproducibility.

Results

The results section could be improved by including more direct quotes from participants to enrich the qualitative data.

There is a need for a clearer connection between the qualitative themes and the quantitative measures to provide a more integrated understanding of the findings.

Discussion

The discussion could be more focused, with less repetition of the results.

Potential biases and limitations of the study, such as the small sample size and the subjective nature of qualitative analysis, should be discussed in more detail.

Future research directions should be outlined more explicitly, providing a clear path for subsequent studies.

Additional Comments

Formatting and Style: The manuscript is well-structured and written in a clear. However, some sections could benefit from minor grammatical revisions to enhance readability.

Ethical Considerations: The ethical considerations are well addressed, but more detail on how confidentiality and anonymity were maintained during the qualitative data collection would be beneficial.

Data Availability Statement: The data availability statement needs to be more precise about what data can be shared and under what conditions, ensuring compliance with PLOS ONE’s data policy

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Reviewer #1: No

Reviewer #2: No

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Rock Steady Boxing: A qualitative evaluation of a community exercise program for people with Parkinson’s disease

PONE-D-24-17855R1

Dear Dr. Regan,

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,

Tanja Grubić Kezele, Ph.D., M.D.

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

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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: 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 #2: 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 #2: The authors have addressed all the concerns, the paper is improved and do not need any further adjustments from my perspective

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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

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