Reviewer ’s report  
 
Title: Modified Pilates  as an adjunct to standard physiotherapy care for urinary incontinence: a 
mixed methods pilot for a randomised controlled trial  
 
Version: 0 Date: 13 Dec 2016  
 
Reviewer: Cornelia Betschart  
 
Reviewer's report:  
 
This study investigated an interesting topic as standard physiotherapy as well as Pilates enjoy 
both a high popularity. The manus cript is well written, the data are clearly presented and the 
weaknesses are disclosed.  
  
Introduction and Material and Methods:  
The introduction is comprehensive. The questionnaires are standardized, validated outcome 
measures.  
On page 4, line 21 you des cribe the Modified Pilates (MP). Could you please explain the 
rationale or hypothesis why MP should improve incontinence?  
 
Results:  
Page 10, first paragraph of the results, first sentence of the paragraph of the baseline 
characteristics and on page 11, l ine 6 -7, these are all statistical descriptions. In my opinion these 
descriptions belong to the section of the statistical analysis and not in the results.  
Page 11, line 6: which kind of Wilcoxon -tests did you conduct? The Wilcoxon signed -rank test 
or th e Wilcoxon -Mann -Whitney test in order to compare the differences between the SPC and 
SPC+MP?  
 
Discussion:  
It is a matter of regret that the study sample was not powered to establish whether the addition of 
MP classes is of benefit or not.  
It is questiona ble whether the improvements in the subgroups with a low SSI could be reached 
likewise with cognitive -behavioral therapy or some form of group therapy as change in self -
esteem and social embarrassment are not typically attributed to MP training.  
 
Conclusion:  
The first sentence (In summary,….) should be weakened as the study was not powered enough. It 
should rather be stated that the global scores of the pre -post-test differences were comparable 
between the groups.  
 
References: Reference 11 and 21 are the same.  
Table 2, legend: please add the post -test time point (T3, 5months after treatment?)  
Figure 1: I propose that you add the time period of the study (like Jan 2011 -Sept 2013)  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscr ipt: 
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may  in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either n ow or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for pa tents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
None  
 
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