Effect of simulated handball match-induced fatigue on isokinetic hamstring-to-quadriceps ratio and evertor-to-invertor ratio in professional players

Ali Shirani Dastjerdi; Hamed Esmaeili; Morteza Sadeghi; Behzad Bashiri

doi:10.1371/journal.pone.0323978

Peer Review History

Original SubmissionFebruary 19, 2025
19 Feb 2025 Author Response https://doi.org/10.1371/journal.pone.0323978.r001
10 Mar 2025 Decision Letter - Seyed Hamed Mousavi, Editor PONE-D-25-07828 Effect of simulated handball match-induced fatigue on isokinetic hamstring-to-quadriceps ratio and invertor-to-evertor ratio in professional players PLOS ONE Dear Dr. Esmaeili, 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 Apr 24 2025 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. 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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. When completing the data availability statement of the submission form, you indicated that you will make your data available on acceptance. We strongly recommend all authors decide on a data sharing plan before acceptance, as the process can be lengthy and hold up publication timelines. Please note that, though access restrictions are acceptable now, your entire data will need to be made freely accessible if your manuscript is accepted for publication. This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If you are unable to adhere to our open data policy, please kindly revise your statement to explain your reasoning and we will seek the editor's input on an exemption. Please be assured that, once you have provided your new statement, the assessment of your exemption will not hold up the peer review process. [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: Partly 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: The purpose of this quasi-experimental study was to examine the effects of a functional fatigue protocol in handball on muscle group torque for the knee extensors and flexors and ankle invertors and evertors. There appeared to be a need for this study and the study purpose was clear. More information is needed in the methods section. There is some confusion in the presentation of the results, although figures and tables complement the narrative. More specific details are needed in the discussion and a limitations section is needed as well. A more developed presentation on central and peripheral fatigue is needed in the introduction which will serve a section of the discussion well. There were several word choice and word tense errors, as well as errors and inconsistencies in the reference section. See pdf for details comments and questions. Reviewer #2: 1) The authors should justify why eccentric torque was not measured or acknowledge it as a limitation. 2) Consider adding physiological fatigue markers (if available) to validate fatigue protocol 3) Discuss whether the reduction in H:Q and E:I ratios reaches clinically significant thresholds 4) if possible, provide effect size interpretations and confidence intervals 5) Ensure consistency in statistical reporting (rounding, decimal places, p-values) 6) if possible, consider adding a sample size power analysis 7) Expand discussion with comparisons to other team sports 8) Provide practical training recommendations for injury prevention 9) You can benefit from the article https://doi.org/10.31459/turkjkin.1576269. in discussion section: When interpreting H:Q ratio reductions and their biomechanical consequences. or in introduction Section: To support the importance of the H:Q ratio in lower limb function. ****** 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: Esedullah AKARAS ******** [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/. 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Revision 1
27 Mar 2025 Author Response Reviewer #1: The purpose of this quasi-experimental study was to examine the effects of a functional fatigue protocol in handball on muscle group torque for the knee extensors and flexors and ankle invertors and evertors. There appeared to be a need for this study and the study purpose was clear. More information is needed in the methods section. There is some confusion in the presentation of the results, although figures and tables complement the narrative. More specific details are needed in the discussion and a limitations section is needed as well. A more developed presentation on central and peripheral fatigue is needed in the introduction which will serve a section of the discussion well. There were several word choice and word tense errors, as well as errors and inconsistencies in the reference section. See pdf for details comments and questions. Thank you very much for your thorough evaluation and thoughtful suggestions. We greatly value your feedback, and we believe that the revisions we have made in response to your comments, especially in the methodology section, have significantly strengthened our manuscript. Below, we highlight the key changes implemented in response to your comments: Regarding intermittent sport: Intermittent sport, often referred to as intermittent exercise or interval training, involves alternating periods of high-intensity activity with periods of lower-intensity activity or rest. So, Handball is an intermittent sport. Your introduction to the concept of fatigue is superficial and appears to only apply to peripheral fatigue. Please more fully develop the concepts of peripheral and central fatigue first, then perhaps show the readers that the fatigue you are interested in mostly is related to peripheral fatigue. This needs to be well-referenced. We have now expanded the introduction and discussion sections to include both peripheral and central fatigue. We have also added the following to the manuscript: Sample size calculation Inclusion criteria General warm up A reference on the test-retest reliability of Borg scale measure Peak torque per body mass considered for measurements A brief description of the problem and the rationale/need for this study before restating the purpose Expanded operational definitions of general and local fatigue in the discussion and introduction Limitation section --------------------- Reviewer #2: Thank you very much for your detailed review and constructive feedback. We appreciate your insights, which have helped strengthen our manuscript. The comments have been addressed and highlighted in the text. Please see our responses to each comment below. 1) The authors should justify why eccentric torque was not measured or acknowledge it as a limitation. We have acknowledged this as a limitation in the manuscript. 2) Consider adding physiological fatigue markers (if available) to validate fatigue protocol We have added physiological markers (Table 1) and expanded the discussion by adding the following: “The proposed fatigue protocol was designed to induce high levels of physiological and psychological stress, ultimately leading to exhaustion. This was evident from the heart rate (HR) at exhaustion, which reached 186.31 ± 7.4 bpm, approximately 96% of the predicted maximum HR. Additionally, participants reported maximum values on the RPE score of 20, further confirming the extreme cardiovascular stress induced by the protocol. These findings, along with the observed reductions in quadriceps, hamstring invertor and evertor muscles peak torque per body mass and their respective ratios, strongly suggest that the protocol effectively induces fatigue. These results indicate that this protocol reliably simulates fatigue in handball players, making it a valuable tool for both training and research.” 3) Discuss whether the reduction in H:Q and E:I ratios reaches clinically significant thresholds We have added the following to the discussion section: “The large effect size (\eta_p^2 > 0.14) demonstrates that the simulated handball game fatigue protocol had a robust and clinically significant impact on knee and ankle musculature peak torques. This large effect size suggests that the simulated handball game fatigue protocol induced significant changes in muscle performance, as measured by peak torques. This is clinically relevant because peak torque is a key indicator of muscle strength and function, which are critical for athletic performance and injury prevention in handball players. For coaches and sports scientists, the large effect size underscores the importance of incorporating fatigue protocols into training regimens to better prepare athletes for the physical demands of competition. By replicating game-like fatigue conditions, athletes can develop greater resilience and adaptability in their knee and ankle musculature.” 4) if possible, provide effect size interpretations and confidence intervals They have been added to the tables as suggested. 5) Ensure consistency in statistical reporting (rounding, decimal places, p-values) We have reviewed the statistical reporting for consistency. 6) if possible, consider adding a sample size power analysis It was added as suggested 7) Expand discussion with comparisons to other team sports We have included compressions with soccer where it was relevant. 8) Provide practical training recommendations for injury prevention We have implemented these recommendations in the discussion. 9) You can benefit from the article https://doi.org/10.31459/turkjkin.1576269. in discussion section: When interpreting H:Q ratio reductions and their biomechanical consequences. or in introduction Section: To support the importance of the H:Q ratio in lower limb function. Thank you so much for providing this valuable reference. We used this reference in the discussion section as suggested: “Additionally, it has been shown that a decreased H:Q is associated with increased loading on the forefoot and toe regions (50). The increased loading could lead to increased risk of stress fracture in the forefoot region (51).” Attachments Attachment Submitted filename: Pone Reviewer Comments-bb.docx https://doi.org/10.1371/journal.pone.0323978.r003
10 Apr 2025 Decision Letter - Seyed Hamed Mousavi, Editor PONE-D-25-07828R1 Effect of simulated handball match-induced fatigue on isokinetic hamstring-to-quadriceps ratio and evertor-to-invertor ratio in professional player PLOS ONE Dear Dr. Esmaeili, 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 25 2025 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, Seyed Hamed Mousavi 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. 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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 ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes 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 #1: Yes Reviewer #2: Yes ****** 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 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 #1: Thank you for addressing the many issues identified. Additional word choice, word tense, and spelling errors remain, some of which were in your highlighted sections so look carefully for my comments. The biggest error was found in the introduction in an incorrect definition of central and peripheral fatigue (see comment and a suggested reference). What was odd was that you correctly discussed central and peripheral fatigue in the discussion section. See pdf for specific comments. 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 #1: No Reviewer #2: Yes: Esedullah AKARAS ******** [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: PONE-D-25-07828_R1_reviewer_reviewer comments.pdf https://doi.org/10.1371/journal.pone.0323978.r004
Revision 2
14 Apr 2025 Author Response Reviewer #1: Thank you for addressing the many issues identified. Additional word choice, word tense, and spelling errors remain, some of which were in your highlighted sections so look carefully for my comments. The biggest error was found in the introduction in an incorrect definition of central and peripheral fatigue (see comment and a suggested reference). What was odd was that you correctly discussed central and peripheral fatigue in the discussion section. See pdf for specific comments. Dear reviewer, Thank you again for reviewing our manuscript and providing your invaluable feedback. We have carefully revised the manuscript to address your suggestions and have clarified the definitions of central and peripheral fatigue in the introduction, incorporating the excellent reference you recommended. Your insights have been incredibly helpful, and we believe these changes have greatly improved the manuscript. Attachments Attachment Submitted filename: Response letter (2).docx https://doi.org/10.1371/journal.pone.0323978.r005
16 Apr 2025 Decision Letter - Seyed Hamed Mousavi, Editor Effect of simulated handball match-induced fatigue on isokinetic hamstring-to-quadriceps ratio and evertor-to-invertor ratio in professional player PONE-D-25-07828R2 Dear Dr. Esmaeili, 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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Seyed Hamed Mousavi Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0323978.r006
Formally Accepted
Acceptance Letter - Seyed Hamed Mousavi, Editor PONE-D-25-07828R2 PLOS ONE Dear Dr. Esmaeili, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset You will receive further instructions from the production team, including instructions on how to review your proof when it is ready. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few days to review your paper and let you know the next and final steps. Lastly, 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 customercare@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. Seyed Hamed Mousavi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0323978.r007

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