Reviewer's report
Title:Effect of Complete decongestive therapy and home program on Health-
Related Quality of Life in Post mastectomy lymphedema patients
Version:2Date:5 October 2015
Reviewer: Melissa Aldrich
Reviewer's report:
major compulsory revisions:
Tables 2 and 3 are un-readable by reviewer--are these superimposed? Please fix
Minor essential revisions:
Please use a native English speaker/writer to review your manuscript before
submission. The time commitment for reviewers increases significantly when you
do not, or when you pay an unqualified English reviewer, and the temptation for
the journal reviewer is to simply reject your manuscript. I spent most of this
morning "fixing" the major problems with the English, but I left a number of minor
problems alone:
Lines 35-37 Change “Edema commonly affects the arm leading to 35 discomfort,
reduced arm movements, pain and shows impact on quality of life. 36 Therefore,
relationship between post mastectomy lymphedema and quality of life has 37
evolved as an important criteria in treatment of breast cancer survivors.” To
“Edema commonly affects the arm, leading to discomfort, reduced arm
movements, pain, and diminished quality of life. Therefore, the relationship
between post-mastectomy lymphedema and quality of life has evolved as an
important criteria in treatment of breast cancer survivors.”
38-40 change “Sixty breast cancer survivors who developed post mastectomy
lymphedema 39 were recruited. Patients were divided into 2 groups (n=30)
according to the treatment 40 they receive; C” to ” Sixty breast cancer survivors
who developed post-mastectomy lymphedema were recruited. Patients were
divided into 2 groups (n=30) according to the treatment they received”
45-47 change “Results: Both the groups showed improvement in pain and quality
of life after 6 weeks 46 of treatment. However, more significant improvement at
5% level was observed in CDT 47 group compared to CT group.” To “Results:
Both groups showed improved quality of life and diminished pain after 6 weeks of
treatment. However, more significant improvement was observed in the CDT
group compared to the CT group.”
48-51 change “Conclusion: In this study, remedial exercises and home program
in addition to manual 49 lymphatic drainage and compression bandaging resulted
in better quality of life. Early 50 identification and incorporating remedial
exercises and a home program helps improve 51 the quality of life among breast
cancer survivor patients.” To “Conclusion: In this study, remedial exercises and a
home care program, in addition to manual lymphatic drainage and compression
bandaging, resulted in better quality of life. Early identification of lymphedema
and incorporation of remedial exercises and a home program improve the quality
of life for breast cancer survivors.”
65-66 change “Post mastectomy 66 lymphedema (PML) is an inevitable
consequence occurring in the breast cancer patients” to “Post-mastectomy
lymphedema (PML) is frequently encountered by breast cancer patients”
79-80 change “3) exercises to enhance lymphatic drainage 4) skin 80 care [17,
18]. MLD was developed in 1930s by Dr. Emil Vodder.” To “3) exercises to
enhance lymphatic drainage, and 4) skin 80 care [17, 18]. MLD was developed in
the 1930s by Dr. Emil Vodder.”
92-94 change “Clinicians require evidence to support the 93 intensity of initial
intensive treatment as well as the importance of each component of 94 CDT.
Progressions in the treatment of breast cancer have led to increased survival
rates” to “Clinicians require evidence to support the intensity of initial intensive
treatment as well as the importance of each component of CDT. Improvements in
breast cancer treatment have led to increased survival rates”
113-115 change “The aim of this article is to evaluate the role of exercise 114
component of CDT and a home program on Health related quality of life in post
115 mastectomy lymphedema patients.” To “The aim of this article is to evaluate
the effect of adding an exercise component and a home program to CDT on
Health related quality of life in post-mastectomy lymphedema patients.”
125 change “Participants’” to “Participants”
131-137 Change “Volunteered 132 participants assessed on Monday were
assigned to CT group whereas participants 133 assessed on Wednesday to CDT
group. Demographic characteristics such as education 134 level, marital status,
type of surgery and affected arm were presented in table1. 135 Majority of the
participants were literates and married. Lymphedema was observed in 136 both
dominant and non-dominant upper limbs. There were no significant differences in
137 the demographic characteristics between the groups p at 0.05.” to “Volunteer
participants assessed on Monday were assigned to the CT group, whereas
participants assessed on Wednesday were assigned to the CDT group.
Demographic characteristics such as education level, marital status, type of
surgery, and affected arm are presented in Table1. The majority of the
participants were literate and married. Lymphedema was observed in both
dominant and non-dominant upper limbs. There were no significant differences in
the demographic characteristics between the groups (p<0.05).”
154-159 change “The patients were comfortably seated, relaxed, place their 155
hand over their abdominal muscles and advice to take deep breathe through
nose and a 156 prolonged expiration through mouth without any strenuous effort.
A 1hour home 157 program involved self -lymphatic drainage, skin care and
remedial exercises. Participants 158 received initial education and training about
home exercises and once they found to be 159 satisfactory the booklets on home
program were given.” To “The patients were comfortably seated, relaxed, placed
their hands over their abdominal muscles, and took deep breaths through the
nose and a prolonged expiration through mouth without any strenuous effort. A
1hour home program involved self -lymphatic drainage, skin care and the
remedial exercises. Participants received booklets on the home program after
initial education and training about home exercises.”
191-192 change “the group. However more significant difference was observed
in CDT group. The figure 2 192 showed values of (QLQ-C30 functional scale)
values.” to “the CT and CDT groups. However, more significant differences were
observed in the CDT group. Figure 2 shows QLQ-C30 functional scale values.”
197-198 Change “Figure 3 showed 198 values of (QLQ-C30 symptom scale)
values within and between groups.” To “Figure 3 shows QLQ-C30 symptom
scale values within and between groups.”
204 change “as shown in and Figures 4 and 5 respectively.” To “as shown in
Figures 4 and 5, respectively.”
209 “as shown in figure 6” to “as shown in Figure 6”
211-213 change “In answer to research question, the findings of the study
indicated that subjects in both 212 the groups had shown improvement in pain
(VAS) and QOL as measured by QLQ-C 30 213 and QLQ-BR 23.” To “The
findings of this study indicate that subjects in both groups showed improvement
in pain (VAS) and QOL as measured by QLQ-C 30 213 and QLQ-BR 23.”
227 define RCT for abbreviation
235-236 change “In contrary, our study explained the role of remedial exercises
and a 236 one hour home program in reducing pain and resulting in
enhancement of QOL” to “In contrast, our study explains the role of remedial
exercises and a one hour home program in reducing pain and enhancing QOL”
237 change “86 article” to “86 articles”
246-240 change “However, these studies have been inconclusive and accurate
247 information on health-related quality of life (HRQOL) outcomes among post
mastectomy 248 lymphedema (PML) patients. It is important since lymphedema
is known to have a 249 significant impact on the physical, psychological, and
social well-being of the patients.” To “However, these studies have been
inconclusive, and accurate information on health-related quality of life (HRQOL)
outcomes among post mastectomy 248 lymphedema (PML) patients is needed. It
is important since lymphedema is known to have a 249 significant impact on the
physical, psychological, and social well-being of the patients.”
256 change “The clinically and statistically relevant” to “Clinically and statistically
relevant”
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I have no competing interests, financial or otherwise