Title: Short-term effects of a new resistance exercise approach on physical function during
chemotherapy after radical breast cancer surgery: a randomized controlled trial
Version: 2 Date: 23 Dec 2023
Reviewer's report:
Dear author
Thank you for your good work. I asked about some issues in the text by comments. please
explain about them.
Page 42: Neuromuscular joint facilitation; radical breast cancer surgery; range of motion;
shoulder joint mobility disorders
The second item is sufficient because it covers the first item (ROM).
Page 55: Shoulder joint dysfunction caused by breast cancer treatment may be related to the
pathological development of the affected rotator.
You have not explained the causes of shoulder dysfunction in these patients.
Page 56: During the post-operative evaluation and 6-month follow-up, patients reported an
increase in shoulder pain intensity and a decrease in shoulder function.
According to witch study???
Page 71: NJF is a new exercise therapy
What is the difference between PNF and NJF (practically).
Page 74: Proximal joint resistance movement is the essential feature of this therapy.
This feature is not just for NJF.
Proprioceptive neuromuscular facilitation (PNF) is an excellent technique for muscle strength
training. It is based on the application of resistance to muscle contraction to facilitate
enhancement of the muscle's contractile force.
Line 90: disorders during chemotherapy within 1–3 months postoperatively.
Line 94: modified radical mastectomy [MRM]/breast-conserving surgery [BCS] or sentinel
lymph node biopsy/BCS/axillary lymph node dissection
Due to the relation between severity of injury (after surgery) and shoulder dysfunction, how you
have distributed the types of surgeries in the groups?
Line 111: The shoulder pain evaluation
VAS was scored at rest or movement?
Line 128: Supraspinatus contraction rate (%) = supraspinatus muscle thickness at 90° active
abduction/supraspinatus muscle thickness at 0° abduction.
References????
Line 136: stretching and strengthening exercises
Have to omit it (stretching)
Line 140: as well as passive and active ROM exercises of the shoulder.
What exercises have you done in this group? Explain. Bring a reference.
Line 145: Each mode was randomly performed three times as passive and resistance exercises.
How??
3 times as passive and 3 times as resistance exercise??
How many times a day???
How many days????
Line 156: comprising suggestions as well as exercise methods for arms and
You have to explain about suggestions and exercises
Line 173: Similarly, the control group exhibited significant increases in all ROM values besides
passive and active external rotation ROM
Similarly to which groups? Complete the sentence (except to …)
Line 176: 01 (before and after).
‡p # 0.05; ‡‡p # 0.01
What you mean??
It is better to add a column to the table and write the amount of P value in them so that there
is no need for various markings
Line 191:
VAS 2.18 ± 1.44 1.24 ± 0.95** 1.74 ± 1.24 1.14 ± 0.83** 1.87 ± 1.30 1.52 ± 1.19**
These scores show that the patients had almost no pain. Don't you think it's strange?
Line 216: four physical therapy sessions improved shoulder joint mobility, pain score, grip
strength, supraspinatus thickness,
Are only four treatment sessions enough to improve muscle strength and thickness?
Line 227: arthrodesis
???? What you mean (arthrodesis means surgical immobilization of a joint by fusion of the bones
Line 239: This study established the supraspinatus muscle contraction rate as a new index for
shoulder dysfunction assessment.
The role of the supra muscle in the evaluation of shoulder dysfunctions is not new and is
investigated in most shoulder lesions.
How far apart are the session’s #
Line 245: However, in the control group, supraspinatus contraction rate significantly decreased
at 60° and 90° abduction between pre-and post-intervention, implying that supraspinatus muscle
contraction capacity will reduce without active motor intervention.
What about NJF group?
Explain what any decrease or increase in supraspinatus contraction rate indicates.
Line 255: grip strength
What was the reason for the improvement in grip strength?
Based on your results, is NGF treatment superior to conventional treatment? Write in the
conclusion