Title: Group-based physical activity interventions for postpartum women with children aged
0-5 years old: A systematic review of randomized controlled trials
Version: 1 Date: 30 Apr 2021
Reviewer's report:
Group-based physical activity interventions for postpartum women with children aged 0-5 years
old: A systematic review and narrative synthesis of randomized and non-randomized controlled
trials.
In general, please pay attention to English writing (grammar and structure). I recommend a
native speaker edit the text thoroughly. My second main concern is about the added value of the
evidence in this review. I believe that more studies with more robust results are needed, but we
know that for many years now. With this information at this time point, what could we conclude
from your review? Please also take note of the comments for each section of the manuscript.
Abstract
- Please do not start off with PA as an abbreviation.
- Typo: “Identified”.
- Throughout the manuscript and in the abstract the author uses different terms for the same
concept, e.g., group exercise program vs group-based PA interventions, or Self-reported PA,
reported PA, self-report PA (in results). Please be consequent.
- Numbers: please write down fully (“seven”) or not (“7”), but be consequent throughout the
entire manuscript.
- 1091 search results drawn back to only 6 papers in the review is quite a large step. I understand
the explanation from Figure 1, but you miss a whole bunch of evidence there. This needs
attention in the discussion.
- Typo: “Women’ “
- “…and utilise objective measures of PA……..” - this is not correct English.
- The recommendations given in the discussion (more trials, longer follow-up, more objective
measures) are those mentioned already for almost a decade of research (in the field of PA
promotion). Given this information, I would expect more attention on what this review adds
to this knowledge. This conclusion could be drawn beforehand. Would it have been wiser to
wait until more studies were performed, because apparently, reviews like this only can conclude
that there aren’t enough robust studies performed? This discussion is something that needs to
be addressed.
Introduction
- “Furthermore, women often do not return to their pre-pregnancy PA levels (14).” Does this only
count for mothers of 0-5yo’s or do these women return to pre-pregnancy levels after 5 years?
Is it only temporary or permanent; a permanent drop of PA? Please elaborate on the magnitude
and long-term-ness of this health problem.
- “There are several reasons for this decline”. I miss the reason for a physical condition here
(back and spine, pelvic problems). I read that you excluded this from your review as post-
partum women with physical constraints are not part of the target population, but at least, in the
introduction this deserves attention. I believe this is the most obvious reason for the lack of PA
amongst mothers of 0-5yo children (or not? Please give it attention in your review).
- (Ref) - missing reference
- Please be consequent when using US or UK English (behaviour vs behavior, for example)
- “Therefore, this review aimed to examine the impact of group-based PA interventions on
postpartum womens’ PA levels or other behavioural outcomes.” What is the impact in this
context? Impact would ideally include effect x reach, which is a more extended concept than
the intervention effects mentioned in the review.
Methods
- The review was performed thoroughly and was reported as such.
- Were MesH terms used or only free text terms? If yes, please mention them in the methods
section.
- “(ii) targeted postpartum women with no current health conditions (e.g., Type 2 diabetes,
postnatal depression);” What about pelvic instability and back and spine problems? Are these
women included in your target population? And if so, what could be the consequence of not
including them?
- I.e., and i.e. (e.g., and e.g.) - please be consequent in punctuation.
- Methodological quality outcomes: I miss these outcomes in the abstract. A proper interpretation
of the results is only possible after knowing how robust the results are.
Results
- 1,091 vs 1091
- 94 to 6! (Six vs 6, be consequent!) —> explain this large spill of results (see my earlier point
under abstract).
- I am curious how many interventions used m-devices or computer-tailored advice/intervention?
Were they combined with face-to-face contact?
- There are only p-values in Table 2. I am curious about the effects in size.
- Table 3 needs a footnote addressing the items of methodological quality. It should be self-
explanatory (even though there is table 3).
- Discussion about the methodological criteria. What does it say that neither of the studies
performed blinded assessments. Was this not feasible? How important is this item?