Brief daily functional strength training to improve functional performance in older adults with mobility disability: A randomized trial

PLOS ONE

Dear Dr. Dandekar,

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Academic Editor

PLOS ONE

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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

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

Reviewer #1: Yes

Reviewer #2: Yes

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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

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4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Dear Editor,

I write to submit my review of the manuscript titled “Brief daily functional strength training to improve functional performance in older adults with mobility disability: A randomized trial.”

The study via randomized trial evaluated the effects of a 12-week brief, home-based functional RT program, FAST (Functional Activity Strength Training)-2, on adherence and functional impairment in older, inactive adults ≥ 65 years of age, with pre-existing walking difficulty.

Comments

1. Kindly explain what informed age stratifiers of 65-72 and 73+ are? Include justification in the manuscript. Is 65 years the official definition of old age in the USA? Why did you consider only those who were greater than 65 years? Why not 60 years, etc? Kindly include justification for the age inclusion threshold.

2. What was the rationale behind the 12-week, delayed-treatment randomized trial? What would have been the effect if the duration had been extended beyond 12 weeks or reduced? The rationale for selecting 12 weeks for implementing the intervention should be included in the manuscript.

3. Major concern: There was no power analysis (sample size calculation) to determine whether the study was powered enough to assess the effectiveness of the intervention if it exists. No properly estimated sample size. The authors initially screened 415 participants and ultimately arrived at 102 for the main study; however, there is no scientific justification for the final sample size of 102. Would the result have been different if only 60 participants had agreed to participate in the study? More rigorous power analysis needs to be conducted to justify the 120 participants

4. For each of the outcome measures, kindly be clear on the measurement scale (continuous, binary, discrete, nominal, ordinal, multinomial outcome) etc. This will determine the appropriateness of the statistical methods employed.

5. The authors stated that “Summary statistics were reported for participant baseline characteristics”. This is too broad. Kindly state the key summary statistics that were reported

6. Include key assumptions of the linear mixed effect model and how these assumptions were tested.

7. Include the limitations of the intention-to-treat estimates

8. Include the mean difference between the intervention and control by creating an additional column before the p-value estimates in Table 1

Reviewer #2: The rationale for study is valid and provides an alternative to current recommendations that are needed for older adults, particularly those with a mobile disability. This FAST-2 program is brief, has appropriate progression, and is easily delivered, with internet access. There was strong adherence to the training program and outcomes show improvements in the training group that will improve the ability to complete ADLs and reduce injury in this population. Methodology is sound and the verification of measured outcomes with a second interpreter is a good added control. A few things should be addressed.

I am concerned about the two-arm seated band rows and the potential for the band to roll up the foot and injure. Did this happen at all in your study? Can you include an alternate exercise targeting similar muscle groups in the discussion as an alternative in case one is not comfortable doing this?

The self-monitoring, feedback, and messaging seems potentially laborious for an older person. Was any data collected on how this what utilized by the subjects or how these affected adherence?

Inclusion of the REDCap survey values, RPEs, and the common exercise modifications the subjects used would be valuable data for inclusion.

PG 13: Either reverse the order of the OLST and the CST in figure2 and table 2, or reverse it in the text so that the order parallels each other.

Include discussion on where the subjects land in relation to norms for the functional tests and how this might affect how much they were able to improve, and generally what the scores for the people at baseline and in the control group translate to.

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Reviewer #1: No

Reviewer #2: No

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Brief daily functional strength training to improve functional performance in older adults with mobility disability: A randomized trial

PLOS One

Dear Dr. Dandekar,

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 Feb 20 2026 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.

• A 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,

Leonardo Roever PhD, MBA

Academic Editor

PLOS One

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #1: All comments have been addressed

Reviewer #2: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions??>

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

Reviewer #1: (No Response)

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

**********

Reviewer #1: The authors have comprehensively addressed all the comments and concerns raised in my previous review of the manuscript

Reviewer #2: The rationale for study is valid and provides an alternative to current recommendations that are needed for older adults, particularly those with a mobile disability. This FAST-2 program is brief, has appropriate progression, and is easily delivered, with internet access. However, some reviewer concerns were not adequately addressed and incorporated into the text of the revision. See below

L131-133: The answer to reviewer 1 comment was inadequately incorporated. Add the additional context that's included in the response to reviewers.

L194-197: Add that feet remained flat on floor to prevent rolling of band/ injury.

Section “Self-monitoring, feedback, and messaging” : Include text from response to reviewers that highlight this is not a burden.

Reviewer 2, #3: The purpose of this manuscript is clear, Inclusion of the requested data either as a table or in text aids this and gives more information about the strain on participants, the movement capacity and ability of the participants, and therefore the feasibility to support adoption of this program. This detail is needed to change current practice.

Reviewer 2, #5: I was able to find values and indicators for the FTSTS, the OLST, 30s chair stand test. Not knowing how these participants compare to the population they represent or a related population is a major limitation.

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Reviewer #1: No

Reviewer #2: No

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NAAS will assess whether your figures meet our technical requirements by comparing each figure against our figure specifications.

<p>Brief daily functional strength training to improve functional performance in older adults with mobility disability: A randomized trial

PONE-D-25-57116R2

Dear Dr. Dandekar,

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Domiziano Tarantino, MD

Academic Editor

PLOS One

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions??>

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

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

**********

Reviewer #1: The authors have comprehensively addressed all the comments and concerns raised in my previous review of the manuscript

Reviewer #2: The authors have carefully considered previous comments. Concerns have been comprehensively and adequately addressed.

**********

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

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