Current applications and outcomes of AI-driven adaptive learning systems in physical rehabilitation science education: A scoping review protocol

Oyindolapo O. Komolafe; Jannatul Mustofa; Mark J. Daley; David Walton; Andrews Tawiah

doi:10.1371/journal.pone.0325649

Peer Review History

Original SubmissionDecember 18, 2024
18 Dec 2024 Author Response https://doi.org/10.1371/journal.pone.0325649.r001
22 Jan 2025 Decision Letter - Somayeh Delavari, Editor PONE-D-24-57782Current Applications and Outcomes of AI-Driven Adaptive Learning Systems in Rehabilitation Science Education: A scoping review protocolPLOS ONE Dear Dr. Komolafe, 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 Mar 08 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. 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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 Additional Editor Comments: Dear Authors Thank you for designing this valuable research project. comments: 1- Please consider PubMed, Scopus, Pedro and onother specific datases in rehabilitation sciences as additional databases. Medline is subcategory of PubMed; you can delete it. 2- Why is this project mix method? 3- The type of review questions is different in various study design. https://bjsm.bmj.com/content/55/22/1246.abstract If there are enough literatures for conducting the present review study, please limit this research project to one of study design category for example observational studies. 4- Please rewrite the background (the abstract) in 3 short sentences: the importance of AI in rehabilitation education, research gap, and the primary outcome 5- If it is possible, please revise review questions according to one of review questions format. 6- Please consider time farmwork and study design as inclusion and exclusion criteria. 7- Please revise key word for searching according to EMTREE and MeSH terms. Be successful. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions? The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ******** 2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses? The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 4. Have the authors described where all data underlying the findings will be made available when the study is complete? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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 Reviewer #3: 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: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics. You may also provide optional suggestions and comments to authors that they might find helpful in planning their study. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Good luck with your upcoming project, I did not see audiology, rehabilitation nursing and physiatry or rehabilitation medicine in rehabilitation sciences field. Please clarify that. Please check the dicataton of "while" in line 135. Reviewer #2: Dear authors, Before all, I would like to thank you for considering this interesting research topic which is now necessary in rehabilitation education. However, I have a few minor comments and questions that require attention and clarification. These are outlined below: 1. Considering that many journals are now indexed in the Scopus database (under Elsevier), I strongly recommend including Scopus as part of the systematic search strategy. 2. Is a quality assessment mandatory in scoping review studies? Please provide clarity on this in the manuscript. 3. In the methodology section, [Line #], kindly introduce JBI as the abbreviation for the Joanna Briggs Instituteupon its first mention. 4. In the discussion section, please elaborate on the rationale for not evaluating the quality of the included studies. 5. Since educational systems vary between countries, it would be helpful to specify the country of each included study and the educational level of participants (e.g., undergraduate or postgraduate students). Reviewer #3: Thanks for dealing with the education in rehabilitation sciences. Please check the text for spelling (lines 135-136, page 10 of PDF file). -The education in rehab sciences (in practice) is a broad and diverse field. In case you find enough study on all the disciplines, discussing the results would be challenging. -Please let the reader know if you include general topics and courses like Anatomy. -Do you use any AI tool in any part of your study? ****** 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: Yes: Holakoo Mohsenifar Reviewer #2: Yes: Mohammad Javaherian Reviewer #3: 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. https://doi.org/10.1371/journal.pone.0325649.r002
Revision 1
25 Feb 2025 Author Response Dear Editorial Team, Thank you for the editorial comments. The latex template on plos one website is used for formatting the protocol. The following are the responses to the questions raised by the reviewers: Question: Please consider PubMed, Scopus, Pedro and other specific databases in rehabilitation sciences as additional databases. Medline is subcategory of PubMed; you can delete it & considering that many journals are now indexed in the Scopus database (under Elsevier), I strongly recommend including Scopus as part of the systematic search strategy. The search database is updated to include Scopus. .The databases searched are Scopus, PubMed, CINAHL, Education Resources Information Center (ERIC), Association for Computing Machinery (ACM), ProQuest Education Journal, Web of Science, ProQuest Dissertations & Theses Global, and IEEE Digital Library Question: Why is this project mix method? The scoping review is not a mixed method, thus removed from the abstract Question: The type of review questions is different in various study design. If there are enough literatures for conducting the present review study, please limit this research project to one of study design category for example observational studies. This research is a scoping review which typically asks broad questions about the scope of research on a topic. According to Peter et al (2020), a scoping review is used to map concepts, identify and analyse gaps, and inform future research. As such, inclusion of different study designs is encouraged in scoping reviews. Question: Please rewrite the background (the abstract) in 3 short sentences: the importance of AI in rehabilitation education, research gap, and the primary outcome The introduction section of the abstract is reduced to meet the requirements Question: If it is possible, please revise review questions according to one of review questions format. We have considered the reviewer’s comment, however, because this research is a scoping review, which typically asks broad questions about the scope of research on a topic, we are confident in the diversity of questions. According to Peter et al (2020), a scoping review is used to map concepts, identify and analyse gaps, and inform future research. Question: Please consider time farmwork and study design as inclusion and exclusion criteria. The inclusion criteria for a scoping review is contingent on the questions posed. The PCC is stipulated (Population, Concept, and Context). Per Peter (2020) we are attempting to develop a broad understanding of the current state of literature pertaining to our research question. As AI tools in education are a relatively new advancement, we do not anticipate a large volume of research especially when limited to only rehabilitation training contexts. Accordingly, we have an opportunity to conduct a review that is both comprehensive and feasible. We respectfully suggest that retaining the broad search strategy is the best approach for our objectives. Question: Please revise key word for searching according to EMTREE and MeSH terms. The search query for Medline and PubMed with the MeSH terms is added to Appendix. The search strategy combines structure database-specific subject headings and keywords/ synonyms of the following concepts: AI models Adaptive learning systems Rehabilitation science (physical therapy, occupational therapy, orthotics, prosthetics, chiropractic, recreation therapy, sports therapy, rehabilitation counseling, kinesiology, cognitive therapy, speech-language pathology and vocational therapy) Question: Is a quality assessment mandatory in scoping review studies? Please provide clarity on this in the manuscript. In the discussion section, please elaborate on the rationale for not evaluating the quality of the included studies. In scoping review, critical appraisal (risk of bias assessment) is not required (Munn et al ,2018 Table 1) but reviewers may decide to access and report bias if it is relevant for their objectives. In our case the goal is to determine the current state of literature, what tools are being used and how, rather than assess the quality or risk of bias of the published manuscripts. This will have the added value of enabling our intention of a broad and comprehensive overview while remaining feasible. Paragraph in this regard has been added to discussion with reference to Munn et al. (lines 200-203) Question: In the methodology section, [Line #], kindly introduce JBI as the abbreviation for the Joanna Briggs Institute upon its first mention. We have updated the protocol to address the suggestion Question: Since educational systems vary between countries, it would be helpful to specify the country of each included study and the educational level of participants (e.g., undergraduate or postgraduate students). Country where study tool place and participants level of education has been added to the Data Extraction table. Thank you for the helpful comment. Question: The education in rehab sciences (in practice) is a broad and diverse field. In case you find enough study on all the disciplines, discussing the results would be challenging. The scoping review is focused on physical rehabilitation science which includes: physical therapy, occupational therapy, orthotics, prosthetics, chiropractic, recreation therapy, sports therapy, rehabilitation counseling, kinesiology, cognitive therapy, speech-language pathology and vocational therapy. We are not including psychological / mental health rehabilitation. Our pilot searches indicate the overall volume of relevant literature will not be so large as to make interpretation and discussion problematic. Question: Please let the reader know if you include general topics and courses like Anatomy. At this point we are keeping the scope intentionally broad meaning we will include any peer-reviewed research exploring use of any AI tool in any physical rehabilitation training program, regardless of whether that is for a single relevant course like anatomy, or used across a program (e.g., for interactive case studies or learning evaluations). The limiting factor is that the manuscript must explicitly state that the course was included as part of a physical rehabilitation professional training program, rather than a general undergraduate course, for example. Question: Do you use any AI tool in any part of your study? No, there is no AI tool used for the scoping review. Sincerely, Oyindolapo Komolafe Western University References Munn, Z., Peters, M.D.J., Stern, C. et al. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol 18, 143 (2018). https://doi.org/10.1186/s12874-018-0611-x Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Scoping Reviews (2020). Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis. JBI; 2024. Available from: https://synthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-24-09 Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0325649.r003
24 Mar 2025 Decision Letter - Somayeh Delavari, Editor PONE-D-24-57782R1Current Applications and Outcomes of AI-Driven Adaptive Learning Systems in Physical Rehabilitation Science Education: A scoping review protocolPLOS ONE Dear Dr. Komolafe, 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 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, Somayeh Delavari, Ph.D., 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. Additional Editor Comments: Dear Athors Thank you so much for revising the manuscript. Please check the line 136; you repeated "AND" for twice. Kind Regards. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author Review Comments to the Author Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics. You may also provide optional suggestions and comments to authors that they might find helpful in planning their study. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: After thoroughly reviewing this manuscript, all of the questions have been addressed, and it has been accepted. Reviewer #3: -Please replace "Rehabilitation Sciences" instead of "Rehabilitation Science" in the title and manuscript. -Please let the readers know why your search didn't include optometry and audiology. -You have focused on "Physical rehabilitation". Please let the readers know why you include cognitive therapy. -Although "adaptive learning" has been considered in the process, the main questions do not reflect it. -Please define education clearly; does it also include evaluation and assessment (It should be). 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. https://doi.org/10.1371/journal.pone.0325649.r004
Revision 2
30 Apr 2025 Author Response Question: Please let the readers know why your search didn't include optometry and audiology. Audiology has been included in the search strategy. The definition of Physical Rehabilitation is stated to justify the inclusion of the disciplines (lines 22-28) Question: You have focused on "Physical rehabilitation". Please let the readers know why you include cognitive therapy. Cognitive therapy has been removed from the protocol and search strategy Question: Although "adaptive learning" has been considered in the process, the main questions do not reflect it As outlined in the introduction (lines 1-8), we define adaptive learning as the use of AI-driven technology to personalize the learning experience, including aspects such as content delivery, evaluation, and assessment. Our intention with the current formulation of the research questions is to take a broad and inclusive approach to understanding how AI technologies—particularly those with adaptive capabilities—are being utilized within physical rehabilitation science education. -While the term adaptive learning is not explicitly mentioned in the research questions, it is conceptually embedded in our first question, which explores the types of AI models and their applications in enhancing teaching and learning. This phrasing was chosen to capture both general AI applications and those that include adaptive learning features such as personalization, real-time feedback, and learner-specific modifications. Question: Please define education clearly; does it also include evaluation and assessment (It should be). Thank you for this thoughtful observation. We agree that education, particularly in the context of adaptive learning, should be clearly defined to encompass not only instructional delivery but also evaluation and assessment. To address this, we have revised the introduction to explicitly define education as a multidimensional process that includes teaching, learning, assessment, and feedback. This definition aligns with the mechanisms of adaptive learning systems, which rely heavily on continuous assessment to personalize learning experiences. Attachments Attachment Submitted filename: Response to Reviewers.pdf https://doi.org/10.1371/journal.pone.0325649.r005
18 May 2025 Decision Letter - Somayeh Delavari, Editor Current Applications and Outcomes of AI-Driven Adaptive Learning Systems in Physical Rehabilitation Science Education: A scoping review protocol PONE-D-24-57782R2 Dear Dr. Komolafe, 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, Somayeh Delavari, Ph.D., Academic Editor PLOS ONE ********** https://doi.org/10.1371/journal.pone.0325649.r006
Formally Accepted
Acceptance Letter - Somayeh Delavari, Editor PONE-D-24-57782R2 PLOS ONE Dear Dr. Komolafe, 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. Somayeh Delavari Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0325649.r007

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