Digital Health Behavioural Interventions to Support Physical Activity and Sedentary Behaviour in Adults after Stroke: A Systematic Literature Review with Meta-Analysis of Controlled Trials

Round 1

Reviewer 1 Report

First of all, I would like to thank the editors of the journal for having trusted me to carry out this review. I would also like to thank the authors for their time dedicated to this work.
Next, I would like to make a series of comments in order to contribute to the article on different issues if the authors are willing to do so.

Regarding the summary, it would be good to indicate the methodology followed by the authors.
As for the introduction, it is a good theoretical framework ranging from the most general to the most specific with recent quotations. However, it is recommended to be more specific in the text as this part is considered too long.
The methodology is clear, well structured and allows the reader to follow in detail how the process has been. There are no objections.
The results follow the same tone, although it is true that the figures are not very well observed and, therefore, it would be desirable to include them with a higher image quality.
The discussion is correct and brief, which again emphasizes that this line of work should be followed in the introduction.
The conclusions respond to the objectives and are clear and concise.


I would like to give  a clearer description of the remarks.
It seems to me an excellent work with high possibilities of publication, .
In this sense, I suggest that in the abstract you include a sentence indicating in broad outline how you have carried out the methodology, research design, etc.
Regarding the theoretical framework, I recommend that authors focus on the variables that are part of their work. Although it goes from the most general to the most specific, there is information that can be omitted and in order not to lose the reader's attention, it is recommended that they deal with 1-2 paragraphs per variable.
Regarding the results, they should provide images with higher photographic quality. 

Author Response

Thank you for the thorough comments on our manuscript. The introduction has been modified according to your guidance to be more specific in the text and revised for brevity. For the results section, those are the images generated by Revman and cannot be changed for image quality. Thank you again for your review; we greatly appreciate it.

Reviewer 2 Report

Thank you for the opportunity to review this paper in which authors aim to investigate the effectiveness of digital health interventions in promoting physical activity and reducing sedentary behaviour for stroke patients, and aim to investigate the intervention components that explain intervention effectiveness to further inform intervention development and policy making.

 

Overall I think this is an important topic. However, various parts of the manuscript had repeated information, definitions etc. Combining different outcome measures into one meta-analyses wont make the studies comparable. 

Please see attached document for my additional comments. 

Comments for author File: Comments.pdf

Author Response

Thank you for the review and feedback. We appreciate the detailed revisions and suggestions for the manuscript. We have thoroughly reviewed the guidance line by line and have revised the manuscript accordingly.

 

Page 1

Number 1 - Addressed

Number 2 – Addressed

Number 3 - Addressed

Number 4 - Addressed

Number 5 – Addressed

 

Page 2

Number 1 – Addressed

 

Page 3

Number 1 – Highlight

Number 2 – Addressed

 

Page 4

Number 1 – Addressed

Number 2 – We would like to keep this in written format.

Number 3- Highlight

Number 4- Addressed

Number 5 – Addressed

Number 6- Highlight

Number 7 – Addressed

Number 8 – There were no conflicts present.

Number 9 – Addressed

 

Page 5

Number 1 – Pilot non randomized studies were excluded because they had less robust data and rigorous study characteristics compared to randomized controlled trials.

Number 2 – Addressed

Number 3 – Highlight

Number 4 – Addressed

Number 5 – Addressed

Number 6 – Yes, such as different measured units (cm and m for example).

 

Page 6

Number 1 – Addressed

Number 2 – Addressed

Number 3 – Addressed

Number 5 – Addressed

 

Page 7

Number 1 – Addressed

Number 2 – Addressed

Number 3 – Addressed

Number 4 – Addressed

Number 5 – Addressed

Number 6 – Addressed

 

Page 8

Number 1 – Other biases that may be found that could not be categorized.

Number 2 – Addressed

Number 3 – Addressed

Number 4 - These were the results outputted by Revman.

 

Page 9

Number 1 – These were the results outputted by Revman. The figure for the results is also displayed in the results. As displayed even though various interventions were analyzed, the heterogeneity was low.

 

Page 10

Number 1 – Addressed

Number 2 – Addressed

Number 3 – Addressed

Number 7 – Addressed

Number 8 – Addressed

Number 14 – Addressed

 

Page 12

Number 1 – We would like to keep the results in the text so that they are easily accessible to the reader.

 

Page 14

Number 1 – Addressed

Number 4 – We believe that sensitivity analysis provides greater insight since some of the randomized studies had smaller sample sizes.

 

Page 16

Number 1 - These were the results outputted by Revman as discussed above.

 

Page 17

Number 2 – Addressed

Number 3 - Addressed

 

 

Author Response File: Author Response.pdf