Dear Dr. Hassan,

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 Oct 11 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.

• 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'.
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We look forward to receiving your revised manuscript.

Kind regards,

Mohammad Jobair Khan, BSPT, MPH

Academic Editor

PLOS ONE

Journal Requirements:

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

1. 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 

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.  We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match. 

When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section.

3. Thank you for stating the following financial disclosure: 

“The work is supported by the University of Toronto Physical Therapy Department, Ontario Respiratory Care Society Project Grant 178373 (Reid), Canada Foundation for Innovation/Ontario Research Fund Equipment Grant ID 35596 (Reid) and a CIHR Grant ID: PJM 179846 (Rozenberg). Rozenberg also receives research salary support from Temerty Faculty of Medicine and Sandra Faire and Ivan Fecan Professorship in Rehabilitation Medicine.”

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. Please expand the acronym “CIHR” (as indicated in your financial disclosure) so that it states the name of your funders in full.

This information should be included in your cover letter; we will change the online submission form on your behalf.

5. We noted in your submission details that a portion of your manuscript may have been presented or published elsewhere:

“None of the results data or figures were published elsewhere; however, aggregate data from which a sample of data was taken has been published: 

Hassan SA, Bonetti LV, Kasawara KT, Stanbrook MB, Rozenberg D, Reid WD. Loss of Neural Automaticity Contributes to Slower Walking in COPD Patients. Cells. 2022 May 11;11(10):1606. 

This has been appropriately cited with in the article text.”

Please clarify whether this [conference proceeding or publication] was peer-reviewed and formally published. If this work was previously peer-reviewed and published, in the cover letter please provide the reason that this work does not constitute dual publication and should be included in the current manuscript.

6. In the online submission form, you indicated that:

“Data can be made available upon request from the corresponding author, subject to approval.”

All PLOS journals now require all data underlying the findings described in their manuscript to be freely available to other researchers, either 

1. In a public repository, 

2. Within the manuscript itself, or 

3. Uploaded as supplementary information.

This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If your data cannot be made publicly available for ethical or legal reasons (e.g., public availability would compromise patient privacy), please explain your reasons on resubmission and your exemption request will be escalated for approval. 

7. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. 

8. Please upload a copy of Figure 4, to which you refer in your text on page 4. If the figure is no longer to be included as part of the submission please remove all reference to it within the text.

9. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information.

10. We note you have not yet provided a protocols.io PDF version of your protocol and/or a protocols.io DOI. When you submit your revision, please provide a PDF version of your protocol as generated by protocols.io (the file will have the protocols.io logo in the upper right corner of the first page) as a Supporting Information file. The filename should be S1_file.pdf, and you should enter “S1 File” into the Description field. Any additional protocols should be numbered S2, S3, and so on. Please also follow the instructions for Supporting Information captions [https://journals.plos.org/plosone/s/supporting-information#loc-captions]. The title in the caption should read: “Step-by-step protocol, also available on protocols.io.”

Please assign your protocol a protocols.io DOI, if you have not already done so, and include the following line in the Materials and Methods section of your manuscript: “The protocol described in this peer-reviewed article is published on protocols.io (https://dx.doi.org/10.17504/protocols.io.[...]) and is included for printing purposes as S1 File.” You should also supply the DOI in the Protocols.io DOI field of the submission form when you submit your revision.

If you have not yet uploaded your protocol to protocols.io, you are invited to use the platform’s protocol entry service [https://www.protocols.io/we-enter-protocols] for doing so, at no charge. Through this service, the team at protocols.io will enter your protocol for you and format it in a way that takes advantage of the platform’s features. When submitting your protocol to the protocol entry service please include the customer code PLOS2022 in the Note field and indicate that your protocol is associated with a PLOS ONE Lab Protocol Submission. You should also include the title and manuscript number of your PLOS ONE submission.

11. If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. 

Additional Editor Comments:

1. Restructure the Manuscript:

Please revise your manuscript to follow the Author’s Instructions provided by PLOS ONE. This includes organizing your sections according to the journal’s recommended structure. Can be followed “Effect of upper limb isometric training (ULIT) on hamstring strength in early postoperative anterior cruciate ligament reconstruction patients: Study protocol for a randomized controlled trial”

2. Detailed Methods Section:

Expand your Methods section to include all relevant details. Please provide a clear description of how the sample size was determined and any assumptions made.

3. SPIRIT Guideline Compliance:

Ensure that your manuscript adheres to the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) reporting guideline throughout. This will enhance the transparency and reproducibility of your research. Alternatively, which one is applied per study design.

4. Discussion Section:

Please add a comprehensive Discussion section that discuss your findings in the context of existing literature, addresses study limitations, and suggests implications for future research.

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

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

?>

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the protocol been described in sufficient detail??>

To answer this question, please click the link to protocols.io in the Materials and Methods section of the manuscript (if a link has been provided) or consult the step-by-step protocol in the Supporting Information files.

Reviewer #1: Partly

Reviewer #2: Yes

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3. Does the protocol describe a validated method??>

Reviewer #1: No

Reviewer #2: Yes

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4. If the manuscript contains new data, have the authors made this data fully available??>

The PLOS Data policy

Reviewer #1: No

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: This pilot study aims to assess the interaction and potential decrements when simultaneously performing cognitive and motor tasks using a dual-task experimental paradigm.

TITLE:

Specify the study design, for example: observational, retrospective, pilot.

ABSTRACT:

- Please clarify the aim of the study more explicitly. While it can be inferred, it's better to state it clearly.

- Include key prognostic data.

- Clearly mention that it is a pilot study (No results).

INTRODUCTION:

to better contextualize the following sentence:“Although cognitive impairment and the critical role of the brain in motor control are well described for neurologic conditions...”, you might add that dual-task approaches, especially when combined with goal-oriented training, are often essential to achieve more efficient and functional rehabilitation outcomes (DOI: 10.5535/arm.23086).

METHODS:

Clarify that this is a pilot study (no results).

FIGURE 1:

Provide a clearer explanation of Figure 1 in the main text—its content and relevance should be made more understandable to the reader.

Reviewer #2: To further strengthen the manuscript, I recommend the following:

Minor typographical issues occur throughout (e.g., inconsistent hyphenation of “dual-task,” “carry over” instead of “carryover,” and shifting tenses).

The Introduction is overly long, and the second paragraph seems only tangentially related to the article’s central purpose.

fMRI is not defined when first mentioned in the Introduction.

In the Expected Results section, the sentence “Sample data for an older adult and COPD participant is presented in Table 1 and Figure 4” appears to be an error — it likely refers to Figure 1.

Clarify the specific novelty of this protocol in contrast to prior publications by the group.

Justify the use of illustrative (n=2) data more explicitly in the Abstract or Methods.

Ensure consistent terminology and notation for ΔO2Hb/O2Hb across figures and text.

Break longer paragraphs in the Introduction to improve readability and focus on content directly related to the protocol.

Consider adding visual aids (e.g., a schematic of task order) to enhance protocol clarity.

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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.

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Reviewer #1: No

Reviewer #2: No

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[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.

Motor-Cognitive Analysis of Dual task Walking in Chronic Obstructive Pulmonary Disease Patients: An observational study using functional Near Infrared Spectroscopy

PONE-D-25-15334R1

Dear Prof. Darlene Reid,

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,

Mohammad Jobair Khan, BSPT, MPH

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: