PONE-D-23-36610Relationships between Physical Activity Frequency in leisure time and: pain, pain impairment and pain medication use in the Spanish adult population. A cross-sectional studyPLOS ONE

Dear Dr. Castillo-Paredes,

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. The points raised by both the reviewers is very important to improve the quality of the paper, hence these comments has to be incorporated in the revised manuscript.  

Please submit your revised manuscript by Mar 10 2024 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,

Strong P Marbaniang

Academic Editor

PLOS ONE

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1. When submitting your revision, we need you to address these additional requirements.

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 

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3. Thank you for stating the following financial disclosure: 

The APC was funded by the Open Access Program of Universidad de Las Américas

Please state what role the funders took in the study.  If the funders had no role, please state: "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript." 

If this statement is not correct you must amend it as needed. 

Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf.

4. Thank you for stating the following in the Acknowledgments Section of your manuscript: 

The author A.D.-Z. (FPU20/04201) was supported by a grant from the Spanish Ministry of Education, Culture and Sport. Grants FPU20/04201 funded by MCIN/AEI/10.13039/501100011033 and, as appropriate, by “European Social Found Investing in your future” or by “European Union NextGenerationEU/PRTR”. The author R.P.-C. was supported with a grant by the Valhondo Calaff Foundation (Caceres, Spain)We also thank the Universidad de Las Américas for their support of the Open Access initiative.

We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. 

Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: 

The APC was funded by the Open Access Program of Universidad de Las Américas

Please include your amended statements within your cover letter; we will change the online submission form on your behalf.

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6. Please include your tables as part of your main manuscript and remove the individual files. Please note that supplementary tables (should remain/ be uploaded) as separate "supporting information" files.

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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

**********

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

Reviewer #1: No

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: No

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: No

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: Theoretical Level:

1. Clarity and Depth in Theoretical Framework:

o The article presents a solid theoretical framework but lacks a more explicit connection between the theories presented and their application in the study.

o It is suggested that the theoretical discussion be expanded to highlight how existing theories relate directly to the research in question. This will help strengthen the conceptual basis of the study and give coherence to the analysis.

Methodological Level:

2. Details and Clarity of Methodology:

o The methodological description is fairly concise and could be more detailed to allow for accurate replication of the study by other researchers.

o It is recommended that the methodological section be expanded to include more information about the study design, sample selection, instruments used and specific procedures. This will increase the reliability and validity of the results.

Bibliographical references:

3. Updating and Extending References:

o Bibliographic references are adequate but could benefit from more diversity and updating, especially in relation to the most recent developments in the field.

o Seek out and add new and recent research sources that support and enrich the arguments presented. This will strengthen the credibility of the article by demonstrating a thorough understanding of the current state of the field.

Reviewer #2: The manuscript examines the how physical activity can influence pain. I find the paper well-written, and it has the potential to contribute to the existing literature. However, I have some comments I would like the authors to consider.

INTRODUCTION:

The present study is conducted in the Spanish population. In line 64 to 66, authors relate high treatment costs and the access to treatment with social classes, but in Spain there is a public health system that covers the major part of the costs and is accessible for the whole population.

MATERIAL AND METHODS:

Why do the authors conduct the study with data from interviews of two different years?

In line 109 authors refers to the methodology of the surveys, could you add the reference where that methodology can be find?

The exclusion and inclusion criteria are explained in the participants section, but in the flowchart depicted in Figure 1 there are more exclusion criteria that are not explained in the participants section. In my opinion, all the exclusion criteria should be explained in that section.

In line 132-133 it is written: Overweight (BMI between 25 and <30), and Obesity (BMI >30). In which group are included those with BMI=30?

It should be explained that the variable pain medication is a combination of two items and that this variable is not an item of the Interview. It is confusing that the authors just consider “created variables” Pain Status and Pain affect, while pain medication is also created by the authors.

In my opinion, line 212 should be written as: “the significance level for the analyses was established at 0.05” as the significance level is a number, not an interval.

RESULTS:

A lot of information of the results is shown in additional files, some relevant results could be move to the main manuscript.

Could you please specify the p value? Writing p<0.05 does not bring much more information than that the result is significant.

Authors wrote the OR value, but they do not interpret the meaning of that value. That information is important and it should be explained in the results. Furthermore, when explaining the results, authors wrote: “being female increases the odds of pain (OR:1.973; 95 IC 1.856-2.098) and (OR: 1.866; 95 IC 1.751-1.989) times” What does that “times” mean? This is one example, but it is repeated in several sentences.

TABLES AND FIGURES:

Figures are clear and help to read and follow the information given in the manuscript. In Figure 1 y-axes represent different numbers, some of them represent from 0 to 55 and others from 0 to 45.

In Table 1 It is written: “The significance level set at p<0.001” but in the Material and Methods section it says that the significance level is set at 0.05.

There is a mistake in Additional file 6, It is written “Addiotional”

In some Additional files differences that are significant are highlighted with abc, Why do you use different letters? Is there any difference between cells highlighted with a, with b or with c? Furthermore, in other files the significant cells are highlighted with *. I would suggest to the authors that they unify criteria.

DISCUSSION:

The following sentence is unclear: “In contrast, in our sample those who were 288 active or very active, the prevalence obtained for these variables were the lowest” Which variables do the authors refer to?

Please clarify the following sentence (line 291): “several studies in multiple populations have shown an relations between 292 pain scores and physical activity”

Finally, in sentence 296 authors refer to “people who were active several times a month or a week”. People who are considered active should do exercise continuously, someone who do exercise one week and not the next, or one month and not the next month should not be considered active.

Finally, In the limitations authors explain the possible bias due to the outbreak in Spain and its possible impact in the interview, but there is a Spanish National Health Interview in 2017. Did the authors consider used that interview? Furthermore, I do not totally understand why authors used interviews from two years if the study could have been conducted with interviews from just one year as they do not make any comparison between results in the different years.

**********

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: No

**********

[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.

Attachments

Attachment

Submitted filename: review.docx

PONE-D-23-36610R1Relationships between Physical Activity Frequency in leisure time and: pain, pain impairment and pain medication use in the Spanish adult population. A cross-sectional studyPLOS ONE

Dear Dr. Castillo-Paredes,

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 May 08 2024 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,

Strong P Marbaniang

Academic Editor

PLOS ONE

Journal Requirements:

Additional Editor Comments:

The authors has to take importance on the theoretical concept of this paper needs to elaborate further as suggested by the reviewer. Also, the reviewer has comment on the validity of the methodology used

Incorporate all the comments and suggestion by the two reviewers

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer 1:

Theoretical Level:

1. Clarity and Depth in Theoretical Framework:

o The article presents a solid theoretical framework but lacks a more explicit connection between the theories presented and their application in the study.

o It is suggested that the theoretical discussion be expanded to highlight how existing theories relate directly to the research in question. This will help strengthen the conceptual basis of the study and give coherence to the analysis.

Methodological Level:

2. Details and Clarity of Methodology:

o The methodological description is fairly concise and could be more detailed to allow for accurate replication of the study by other researchers.

o It is recommended that the methodological section be expanded to include more information about the study design, sample selection, instruments used and specific procedures. This will increase the reliability and validity of the results.

Bibliographical references:

3. Updating and Extending References:

o Bibliographic references are adequate but could benefit from more diversity and updating, especially in relation to the most recent developments in the field.

o Seek out and add new and recent research sources that support and enrich the arguments presented. This will strengthen the credibility of the article by demonstrating a thorough understanding of the current state of the field.

Reviewer 2:

The manuscript examines the how physical activity can influence pain. I find the paper well-written, and it has the potential to contribute to the existing literature. However, I have some comments I would like the authors to consider.

INTRODUCTION:

The present study is conducted in the Spanish population. In line 64 to 66, authors relate high treatment costs and the access to treatment with social classes, but in Spain there is a public health system that covers the major part of the costs and is accessible for the whole population.

MATERIAL AND METHODS:

Why do the authors conduct the study with data from interviews of two different years?

In line 109 authors refers to the methodology of the surveys, could you add the reference where that methodology can be find?

The exclusion and inclusion criteria are explained in the participants section, but in the flowchart depicted in Figure 1 there are more exclusion criteria that are not explained in the participants section. In my opinion, all the exclusion criteria should be explained in that section.

In line 132-133 it is written: Overweight (BMI between 25 and <30), and Obesity (BMI >30). In which group are included those with BMI=30?

It should be explained that the variable pain medication is a combination of two items and that this variable is not an item of the Interview. It is confusing that the authors just consider “created variables” Pain Status and Pain affect, while pain medication is also created by the authors.

In my opinion, line 212 should be written as: “the significance level for the analyses was established at 0.05” as the significance level is a number, not an interval.

RESULTS:

A lot of information of the results is shown in additional files, some relevant results could be move to the main manuscript.

Could you please specify the p value? Writing p<0.05 does not bring much more information than that the result is significant.

Authors wrote the OR value, but they do not interpret the meaning of that value. That information is important and it should be explained in the results. Furthermore, when explaining the results, authors wrote: “being female increases the odds of pain (OR:1.973; 95 IC 1.856-2.098) and (OR: 1.866; 95 IC 1.751-1.989) times” What does that “times” mean? This is one example, but it is repeated in several sentences.

TABLES AND FIGURES:

Figures are clear and help to read and follow the information given in the manuscript. In Figure 1 y-axes represent different numbers, some of them represent from 0 to 55 and others from 0 to 45.

In Table 1 It is written: “The significance level set at p<0.001” but in the Material and Methods section it says that the significance level is set at 0.05.

There is a mistake in Additional file 6, It is written “Addiotional”

In some Additional files differences that are significant are highlighted with abc, Why do you use different letters? Is there any difference between cells highlighted with a, with b or with c? Furthermore, in other files the significant cells are highlighted with *. I would suggest to the authors that they unify criteria.

DISCUSSION:

The following sentence is unclear: “In contrast, in our sample those who were 288 active or very active, the prevalence obtained for these variables were the lowest” Which variables do the authors refer to?

Please clarify the following sentence (line 291): “several studies in multiple populations have shown an relations between 292 pain scores and physical activity”

Finally, in sentence 296 authors refer to “people who were active several times a month or a week”. People who are considered active should do exercise continuously, someone who do exercise one week and not the next, or one month and not the next month should not be considered active.

Finally, In the limitations authors explain the possible bias due to the outbreak in Spain and its possible impact in the interview, but there is a Spanish National Health Interview in 2017. Did the authors consider used that interview? Furthermore, I do not totally understand why authors used interviews from two years if the study could have been conducted with interviews from just one year as they do not make any comparison between results in the different years.

[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.

PONE-D-23-36610R2Relationships between Physical Activity Frequency in leisure time and: pain, pain impairment and pain medication use in the Spanish adult population. A cross-sectional studyPLOS ONE

Dear Dr. Castillo-Paredes,

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 Sep 26 2024 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,

André Pontes-Silva

Academic Editor

PLOS ONE

Additional Editor Comments:

First of all, thank you for submitting your manuscript to Plos One. I would like to congratulate you on your research. I was asked to make the final decision on this article and I noticed that it has already gone through previous revisions. The study has interesting analyses, so please provide the database with the data in unanalyzed values (i.e. absolute values) as a supplementary file (Excel and English).

[Note: HTML markup is below. Please do not edit.]

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

**********

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

**********

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)

**********

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

**********

[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.

Attachments

Attachment

Submitted filename: reviewII.docx

PONE-D-23-36610R3Relationships between Physical Activity Frequency in leisure time and: pain, pain impairment and pain medication use in the Spanish adult population. A cross-sectional studyPLOS ONE

Dear Dr. Castillo-Paredes,

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.

==============================

Dear Dr. Castillo-Paredes, thank you for the corrections and clarifications regarding your article. After careful review, I would like to ask you to kindly make the final adjustments.

• Your title is long and not very intuitive. I suggest you change it to “Frequency of physical activity during leisure time and its effect on pain variables and medication use: A Spanish Cross-Sectional Study”. Think about whether this makes sense for your study (it is just a suggestion).
• ​Organize the abstract into topics (Background [research question]; Objective; Methods; Results; Conclusion).
• The objective stated in your abstract is different from the objective stated in your introduction. Please correct this. The sentence describing the objective must be exactly the same in both.
• In the methods section, include a topic called "Sample Size" and explain in detail the sampling strategies used in this study.
• In the conclusion, objectively describe your final considerations in a single paragraph. Avoid phrases like “Based on the results of this study” or “In our sample the results of this study”. The conclusion described in the abstract and the conclusion described after the discussion must be exactly the same.

​==============================

Please submit your revised manuscript by Oct 03 2024 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,

André Pontes-Silva

Academic Editor

PLOS ONE

Journal Requirements:

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.

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Frequency of Physical Activity During Leisure Time and Variables Related to Pain and Pain Medication Use in Spanish Adults: A Cross-sectional Study

PONE-D-23-36610R4

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