Reviewer’s report
Title: 
EFFECT OF PAULA EXERCISE METHOD ON FUNCTIONAL
OUTCOMES OF WOMEN WITH POST FISTULA REPAIR
INCONTINENCE: A PROTOCOL FOR RANDOMIZED CONTROLLED
TRIAL
Version: 
0 
Date: 
14 Oct 2020
Reviewer: 
Anna Szumilewicz
Reviewer's report:
The authors have taken a very important and valuable topic of the effectiveness
of two different exercise programmes for pelvic floor muscles: performed with
the Paula method and in a traditional form of 'Kegels exercises", in women with
post fistula repair incontinence.
First of all, I would like to congratulate the authors for their work. This is a very
good study protocol. Certainly, the study will result in very interesting outcomes,
which may be useful for the practice of physiotherapists and exercise
professionals. 
However in my opinion some corrections of this manuscript should be done.
Suggested major changes: 
1. Please describe in details the exercise intervention programmes for both
groups. Especially when it is a study protocol, some key information is
necessary, e.g. how many sets, exercise repetitions in one set and which intensity
of exercise are planned; in which positions the study women will exercise; will it
be only pelvic floor muscle exercises or also any others for various muscle
groups; will the sessions be supervised by any exercise specialist or
physiotherapist or will it be an exercise programme to be perform at home; will
you use any equipment; how the adherence to exercise programme will be
reported, etc.?
Please follow the CERT standards (1).
2. Please, rename "Kegels exercises" for "traditional pelvic floor muscle
exercises" - following the recommendations of International Urogynecological
Association (IUGA) and International Continence Society (ICS) (2).
Suggested minor changes: 
1. Please specify in the title that this manuscript presents the protocol for RCT.
2. Please check your English. I'm not an English native speaker but I found some
language mistakes in the text.
1. Slade SC, Dionne CE, Underwood M, Buchbinder R. Consensus on Exercise
Reporting Template (CERT): Explanation and Elaboration Statement. British
Journal of Sports Medicine. 2016;50(23):1428-37.
2. Bø K, Frawley H, Haylen B, Abramov Y, Almeida F, Berghmans B, et al. An
International Urogynecological Association (IUGA)/International Continence
Society (ICS) joint report on the terminology for the conservative and
nonpharmacological management of female pelvic floor dysfunction.
International Urogynecology Journal. 2017;28(2):191-213.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
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No
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from apparent manipulation?
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