Retrospective Analysis of Functional Pain among Professional Climbers

Round 1

Reviewer 1 Report

The present study aimed at functional pain locations in climbers according to gender and dominant climbing style. The document requires minor improvements considering this initial format.

INTRODUCTION - It is suggested the improvement of the introduction section.

L 52 – reference missing

L 53- L 62 – in my opinion, it will be better if this paragraph is put at the beginning of the introduction. Think about this…

L 63- reference missing

METHODS

L 82-83 Information about the sample should be provided to readers. Some information about the control group is missing. How was sample determined should also be described.

RESULTS:

Please carefully review the table content, titles, and legends. Also, tables should consider the format according to journal guidelines and provide good conditions for reading and data interpretation

REFERENCES

Please check the references according to journal instructions for authors, please correct them.

Author Response

We are grateful to you for your precious comments that allowed us to improve our paper.

L 52 – reference missing

The gap has been filled in with proper references.

L 53- L 62 – in my opinion, it will be better if this paragraph is put at the beginning of the introduction. Think about this…

L53-L62 describe the object of the study, which is climbing. It seems important to introduce the reader to the subject of climbing before moving on to pain issues. Now, the paragraph has been put at the beginning of the introduction as general information about the main issue of the paper.

L63 reference missing

We would like to thank you for your comment. We are not sure if your note concerns  L63 or L62. We have to agree that L62 “Bad technique habits or the discipline of climbing can contribute to the additional overloading of soft tissue, which in consequence can become a source of pain”  lacks a proper reference. When it comes to L63 (now L65), we have rewritten the sentence. Now it is: “There is a lack of data that would describe chronic pain characteristics among athletes, including climbers”. We have also added there a proper reference.

Methods - L 82-83 Information about the sample should be provided to readers. Some information about the control group is missing. How was sample determined should also be described.

Your indications are very important for us as they allow us to make our paper better. The sample consists of intermediate and experienced Polish climbers who were recruited for the study through social media. The aim was to check the incidence of functional pain in this group. Every effort was made to get a representative group of survey participants. The information about the sample size was provided to readers in paragraph 2.3. As regards the control and study groups, the information about mass, age, height, and BMI has been included and presented in Table 1. We have also added the following information in paragraph 2.1:

“The control group (n=160) consisted of healthy females and males that were not involved in any sports and lived in Poland. The demographic data of this group are presented in Table 1.”

RESULTS: Please carefully review the table content, titles, and legends. Also, tables should consider the format according to journal guidelines and provide good conditions for reading and data interpretation.

We have reviewed the table content, titles, and legends as you suggested.

REFERENCES - Please check the references according to journal instructions for authors, please correct them.

Thank you for highlighting the inconsistency of the references with the journal's instructions. References have been corrected according to the journal’s format.

 

Reviewer 2 Report

Authors did a good job in presenting the motivation and need for their study. I have a couple of methodological comments that I hope will make the paper stronger:

1. Interpretation of coefficients from the probit regression: interpretation of coefficients from probit regression are not straightforward. Authors' interpretation of coefficients resembles the interpretation from the linear probability model. I wasn't sure how authors arrived at this interpretation after using probit regression -- perhaps they need to clarify (and report; perhaps in appendix if necessary) the probit coefficient (raw model output) and any transformation that they used to arrive at current interpretation (e.g., risk being x times higher). Moreover, perhaps authors can clarify why they decided to use probit regression (instead of, say, logistic regression, which is more common with a simple interpretation).

2. Multiple comparison: As the number of tests/comparisons increases, the prospect that the groups will appear to differ with respect to at least one variable increases. Discovered finding from multiple comparisons should be treated differently from the discovered finding with a single comparison (to which the established 0.05 standard etc.. apply). Hence, the p-value ("acceptance bar") in the multiple comparisons need to be adjusted.

3. AUC -- whenever a binary outcome variable is involved, using AUC provides a good measure of an effect size.

Author Response

Dear Reviwer,

We are grateful to you for your precious comments that allowed us to improve our paper.

Authors did a good job in presenting the motivation and need for their study. I have a couple of methodological comments that I hope will make the paper stronger:

We would like to thank you for your kind opinion about our paper and your precious comments.

 

Interpretation of coefficients from the probit regression: interpretation of coefficients from probit regression are not straightforward. Authors' interpretation of coefficients resembles the interpretation from the linear probability model. I wasn't sure how authors arrived at this interpretation after using probit regression -- perhaps they need to clarify (and report; perhaps in appendix if necessary) the probit coefficient (raw model output) and any transformation that they used to arrive at current interpretation (e.g., risk being x times higher). Moreover, perhaps authors can clarify why they decided to use probit regression (instead of, say, logistic regression, which is more common with a simple interpretation).

Thank you for your valuable comment concerning the statistical analysis. Due to your suggestion, we have decided to change the statistical model to logistic regression. To present the results of the logistic analysis, we have used the Odds Ratio (OR) and area under the curve (AUC), which are simple to interpret. We hope that this change will bring a better understanding of the results. 

Multiple comparisons: As the number of tests/comparisons increases, the prospect that the groups will appear to differ with respect to at least one variable increases. Discovered finding from multiple comparisons should be treated differently from the discovered finding with a single comparison (to which the established 0.05 standard etc.. apply). Hence, the p-value ("acceptance bar") in the multiple comparisons need to be adjusted.

We would like to thank you very much for your comments that allowed us to improve our paper. We agree that the p-value in multiple comparisons needs to be adjusted. We have applied the Benjamin-Hochberg correction method to adjust the p values in our statistical analysis. We have also described it in paragraph 2.3. We have used all of the p-values included in logistic regression.

 

 

AUC -- whenever a binary outcome variable is involved, using AUC provides a good measure of effect size.

We agree with your opinion that AUC provides good measure effect of size. We have included AUC for each model of logistic regression in Table 2 and Table 3

 

Reviewer 3 Report

The authors present a paper on the analysis of pain among professional climbers. 

In general, the study is carried out appropriately. However, this reviewer has concerns, as specified below.

General Comments:

1. At the moment, the study design sounds very explorative to the reader. If the study is explorative, it should be stated in the introduction. Otherwise, the theoretical background has to be strengthened by further explaining injury/pain mechanisms in climbing.
2. The authors have to formulate a clear hypothesis of what they expect. Then, if they explain the mechanisms of injury (chronic, not trauma), they could better discuss the findings.

Detailed comments:

1. Line 29: Could you be more specific? What could be assessed in future studies?
2. Line 87: Please verify. Do you mean "route"?
3. Line 126-128: Please provide more information on this point. Did the participants perform a ROM test at home? The point is unclear to the reader.

Author Response

Dear Reviever,

Thank you very much for this kind opinion.

Kindr egards

authors

Author Response File: Author Response.pdf

Reviewer 4 Report

Great article retrospective analysis of functional pain among Professional Climbers became one of the official Olympic sports in 2020.

Author Response

Thank you very much for this kind opinion.

 

kind regards,

authors

Round 2

Reviewer 2 Report

I appreciate authors' addressing all of my concerns. Perhaps very minor editing etc.. may be required (i.e., to ensure em-dash is used instead of en-dash, etc...).

Author Response

We would like to thank you very much for all of your constructive suggestions that helped us to improve the paper. As you suggested, we have had our paper proofread once again.

Reviewer 3 Report

I have no further comments. The quality of the paper has been improved with the revision.

Author Response

We would like to thank you for all of your suggestions that allowed us to improve our paper.

Sincerely,

Authors