Using smartphone step counts to monitor patients with total hip arthroplasty: The impact of patients’ living arrangements and residential location

Satoshi Yamate; Satoshi Hamai; Toshiki Konishi; Yuki Nakao; Takahiro Inoue; Goro Motomura; Yasuharu Nakashima

doi:10.1371/journal.pone.0326338

Peer Review History

Original SubmissionFebruary 24, 2025
24 Feb 2025 Author Response https://doi.org/10.1371/journal.pone.0326338.r001
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If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references.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 If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [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? Reviewer #1: Yes 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 Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: Yes Reviewer #2: Yes ****** Reviewer #1: The research is quite satisfactory as regards methodology and scientific writing. The discussion and conclusions are very useful especially the remark by the authors that there is a breakdown in its traditional social structure and increasing social isolation in the older population in their community and its potential effect on results after hip replacement surgery Reviewer #2: Introduction Are there any studies that investigated the relation between residence and step count after THA. If not, please, mention that in the introduction as this adds to the novelty of your paper Patients and methods Did you use a validated version of HOOS and Oxford for the Japanese population. Results Patient flowchart is not clear. How many patients were excluded and why? Discussion Could you elaborate more on why patients living in Solitude had more step count than cohabiting patients? Was there any relation between PROMs and step count? ****** 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". 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Revision 1
12 Apr 2025 Author Response Response to Reviewer #1: Reviewer #1 (1): The research is quite satisfactory as regards methodology and scientific writing. The discussion and conclusions are very useful especially the remark by the authors that there is a breakdown in its traditional social structure and increasing social isolation in the older population in their community and its potential effect on results after hip replacement surgery Response: We thank the Reviewer #1 for the positive comments. We thank Reviewer #1 for the positive comments. This study is the first to highlight the potential influence of living arrangements and residential location on perioperative physical activity in patients undergoing THA. Response to Reviewer #2: Reviewer #2 (1): Introduction Are there any studies that investigated the relation between residence and step count after THA. If not, please, mention that in the introduction as this adds to the novelty of your paper Response: We are grateful to Reviewer #2 for critical comments and useful suggestions that helped us to improve our paper considerably. As suggested, we have revised the Introduction to clarify that this is the first study to investigate the association between residence and step count after THA. Text Changes (Introduction, Lines 66-68): Therefore, living arrangements and the residential location could also be a crucial factor affecting perioperative activity in THA; however, to the best of our knowledge, these associations have not been previously reported. Reviewer #2 (2): Patients and methods Did you use a validated version of HOOS and Oxford for the Japanese population. Response: We thank Reviewer #2 for the valuable comment. Yes, we used validated Japanese versions of the HOOS and Oxford scores. We have revised the manuscript. Text Changes (Materials and methods, Lines 123-125): For additional analysis, we collected the Oxford Hip Score (OHS) and Hip Disability and Osteoarthritis Outcome Score (HOOS), which are patient-reported outcome measures (PROMs) for hip osteoarthritis, using the validated Japanese versions. Reviewer #2 (3): Results Patient flowchart is not clear. How many patients were excluded and why? Response: We thank Reviewer #2 for the valuable comment. We have clarified the patient flowchart in the manuscript, including the number of excluded patients and the reasons for exclusion. Text Changes (Results, Lines 180-185): Overall, 233 patients were assessed for eligibility. Among them, 60 did not have smartphones or were unable to install the application, leaving 173 patients (74.2%) with compatible smartphones. Of these, 54 declined to participate, and 119 wished to participate in the study. Among the 119 patients, data from 34 were excluded due to incomplete or invalid step-count data. Finally, data from 85 patients who underwent THA and had valid step-count data were included in the analysis (Fig 2). Reviewer #2 (4): Discussion Could you elaborate more on why patients living in Solitude had more step count than cohabiting patients? Response: We thank the Reviewer #2 for the valuable comment. We have revised the text. Text Changes (Discussion, Lines 274-278): Our study found that solitary patients exhibited significantly higher step counts than cohabiting patients during the plateau phase of postoperative recovery, which spanned from postoperative week 20 to week 50, suggesting that living alone may require greater physical autonomy in daily life. This finding may provide helpful information for surgical decision-making. Reviewer #2 (5): Was there any relation between PROMs and step count? Response: We thank the Reviewer #2 for the valuable comment. We have revised the text. Text Changes (Discussion, Lines 265-267): Solitude patients maintained higher activity levels from the preoperative to the postoperative period than cohabiting patients did, a difference that was not captured by OHS or HOOS. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0326338.r003
Decision Letter - Osama Farouk, Editor Using Smartphone Step Counts to Monitor Patients with Total Hip Arthroplasty: The Impact of Patients’ Living Arrangements and Residential Location PONE-D-25-08198R1 Dear Dr. Hamai, 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, Osama Farouk Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions??> 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 Reviewer #2: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #2: Yes ****** Reviewer #2: (No Response) ****** 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 ******** https://doi.org/10.1371/journal.pone.0326338.r004
Formally Accepted
Acceptance Letter - Osama Farouk, Editor PONE-D-25-08198R1 PLOS ONE Dear Dr. Hamai, 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. Osama Farouk Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0326338.r005

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