Analysis of Sports Injury in Lower Extremities of High School Taekwondo Athletes

Round 1

Reviewer 1 Report

The researchers indicate that this study will provide new insights into the frequency and cause of injury but the results do not support this objective.  There needs to be much more clarity of definitions of injury mechanisms.  The injuries are described in very broad terms using only body part and not specific muscle, ligament or other structures that are injured.  Contact sport injuries are not subdivide as offensive (athlete initiates contact on opponent) or defensive injuries.(opponent initiated impact).  Injuries by category would have also added insights to the mechanism of injuries (sprain, strain, overuse etc)

Comments for author File: Comments.docx

Author Response

Applsci-1434942

 

Title: Analysis of sports injury in lower extremities of high school  Taekwondo athletes 1

 

Dear Editor and reviewers

We are grateful for the positive feedback we have received from the editors and reviewers of Applied Sciences. We were elated to find that other experts have acknowledged the clinical significance of our manuscript and we feel indebted for the editors and reviewers for sharing their valuable opinions to upgrade the overall academic value of this paper. We have given full consideration to the comments made by each reviewer and have reflected their opinions in the manuscript. The following are the responses we have made for each comment made by the editors and reviewers.

 

Authors’ response to reviewer

Reviewer’s comment – More clarity on how subjects were recruited.  The authors indicate that 500 athletes were “selected from the over 3000 participants.  How were they “selected” or were questionnaires sent to all requesting a response? Selecting specific athletes could introduce a significant bias.

Dicussion: You must take in account the paper publish in SRA part I,II,(III is quoted)- Dicussion: You must take in account the paper publish in SRA part I,II,(III is quoted)

THE TARSAL TUNNEL – ULTRASOUND-GUIDED ANKLE AND FOOT
DECOMPRESSION SURGERY (UGAFDS) – A MINIMALLY INVASIVE APPROACH
WITH REGARD TO THE PROXIMAL TARSAL TUNNEL SYNDROME
- Fernandez-Gibello A, Moroni S, Camunas G, et al. (2019) Ultrasound-guided decompression surgery of the tarsal tunnel: a novel technique for the proximal tarsal tunnel syndrome-Part II. Surg Radiol Anat 41,1:43-51
- Moroni S, Zwierzina M, Starke V, et al. (2019) Clinical-anatomic mapping of the tarsal tunnel with regard to Baxter's neuropathy in recalcitrant heel pain syndrome: partI. Surg Radiol Anat 41,1:29-41Dicussion: You must take in account the paper publish in SRA part I,II,(III is quoted)

THE TARSAL TUNNEL – ULTRASOUND-GUIDED ANKLE AND FOOT
DECOMPRESSION SURGERY (UGAFDS) – A MINIMALLY INVASIVE APPROACH
WITH REGARD TO THE PROXIMAL TARSAL TUNNEL SYNDROME
- Fernandez-Gibello A, Moroni S, Camunas G, et al. (2019) Ultrasound-guided decompression surgery of the tarsal tunnel: a novel technique for the proximal tarsal tunnel syndrome-Part II. Surg Radiol Anat 41,1:43-51
- Moroni S, Zwierzina M, Starke V, et al. (2019) Clinical-anatomic mapping of the tarsal tunnel with regard to Baxter's neuropathy in recalcitrant heel pain syndrome: partI. Surg Radiol Anat 41,1:29-41Authors’ comment – In this study, a simple random sampling method was applied to select research participants. Of the 3,000 subjects that the examiner said, 500 were randomly sampled using random numbers. However, we selected the participants in the study as a school and team unit, not the athletes. Therefore, we tried our best to perform random sampling which is most representative of the selection of research participants.

Also, when selecting the participants, the Taekwondo team of each high school sent a letter containing the contents and purpose of the study through the Korea Taekwondo Association and conducted a questionnaire to the team or players who are willing to participate voluntarily.

 

Reviewer’s comment –Injury classifications need to be better defined 

Authors’ comment – Injury by person and non-contact injury are defined in Table 2.

(Injury by person: injury caused by contact with the opponent, for example, when the opponent has been hit by the thigh, when the opponent's knee and his knee are hit)

(Non-contact injury: If an individual causes damage regardless of the opponent, for example, if the ankle is broken, if the hamstring is damaged during kicking motion when there is no relative injury)

In addition, the study did not investigate all of the detailed factors by the damage site. There was a limit to consider many factors in one study. We will do more detailed research in the future research and try to develop Taekwondo field.

In the case of injuries and re-injuries, no separate definition was given; injuries were one injury, and re-injury was defined as re-injury if the same area was injured again. In the field of sports, it is a universal word, so I did not define it separately, but if the examiner further judges the definition of the term, I will do the description at any time.

 

Reviewer’s comment – Table 6 shows the comparison of the causes of lower extremity injuries according to 132 the weight classes of the taekwondo athletes for both sexes.

This would not be the cause of injuries but rather the type of injuries (thigh, knee and ankle)

Authors’ comment – I have revised the title of the table with what the reviewer said.

 

Reviewer’s comment – Line 150

In addition, national taekwondo athletes (mostly adults) are reported to sustain 150 several injuries in the lower extremities, including the ankles, knees, and thighs (Park & 151 Song, 2018); Your study does not analyse the incidence of injury by age which might have added more insight into the cause of these injuries.

Authors’ comment – Thank you for your opinion. If the contents of the age group were studied, we would be able to confirm the relationship between player career and injury. However, there is a limitation that this study has been conducted on student-athletes. In the future study, we will investigate the age-related injuries and analyze the relationship. We will present the contents mentioned now in the discussion and put it as a limit.

 

Reviewer’s comment – Line 150

In addition, national taekwondo athletes (mostly adults) are reported to sustain 150 several injuries in the lower extremities, including the ankles, knees, and thighs (Park & 151 Song, 2018); Your study does not analyse the incidence of injury by age which might have added more insight into the cause of these injuries.

Authors’ comment – As mentioned above, the contents of the sampling of the participants were added, and the strengths of the student-athletes that the examiner said in the discussion were compared with the previous studies.

 

Sincerely yours

Email: [email protected]

Reviewer 2 Report

First, consider the hard work that the authors have done. On the other hand, there are several corrections that I contribute to improve the following manuscript.

Major revision

In general, the introduction should be better conducted and be more specific in the subject matter (focus on injuries in taekwondo, or in combat sports). Regarding the bibliographic citations, there are empty spaces that the authors should add a citation. Therefore, I recommend to revise and improve the introduction.

Regarding the methodology, I consider that it is well structured . However, the statistical analysis should be better described, because the authors use a statistic applied to surveys, however, it is not described in the methodology itself. Therefore, please indicate which statistic was used to obtain the P, and the level of significance.

With regard to the discussion, it is well organized and I consider it is a strength of your work. However, you should add more bibliographic citations. Besides, I would recommend to be more specific in the limitations of the study due to the population used is school children. Therefore, it is not representative of taekwondo across a broad spectrum of competitions and ages.

Finally, the conclusion is shorter. Note, the main point is missing, being that the incidence of injuries is produced mainly by injuries without opponent, or in training situations. On the other hand, I consider the final recommendation by the authors right.

 

Minor revision

31-31 Rephrase the sentence for a better understanding

32 and 35 put a space between the name and the year of the quotation.

40-42 Rephrase the sentence and add a reference

51 Add a bibliographic reference

59 Rephrase the sentence since the authors indicated several and only referenced 1. Therefore, classify the cited reference better.

Author Response

Applsci-1434942

 

Title: Analysis of sports injury in lower extremities of high school  Taekwondo athletes 2

Dear Editor and reviewers

 

We are grateful for the positive feedback we have received from the editors and reviewers of Applied Sciences. We were elated to find that other experts have acknowledged the clinical significance of our manuscript and we feel indebted for the editors and reviewers for sharing their valuable opinions to upgrade the overall academic value of this paper. We have given full consideration to the comments made by each reviewer and have reflected their opinions in the manuscript. The following are the responses we have made for each comment made by the editors and reviewers.

 

Authors’ response to reviewer

Reviewer’s comment – In general, the introduction should be better conducted and be more specific in the subject matter (focus on injuries in taekwondo, or in combat sports). Regarding the bibliographic citations, there are empty spaces that the authors should add a citation.Therefore, I recommend to revise and improve the introduction.

Dicussion: You must take in account the paper publish in SRA part I,II,(III is quoted)- Dicussion: You must take in account the paper publish in SRA part I,II,(III is quoted)

THE TARSAL TUNNEL – ULTRASOUND-GUIDED ANKLE AND FOOT
DECOMPRESSION SURGERY (UGAFDS) – A MINIMALLY INVASIVE APPROACH
WITH REGARD TO THE PROXIMAL TARSAL TUNNEL SYNDROME
- Fernandez-Gibello A, Moroni S, Camunas G, et al. (2019) Ultrasound-guided decompression surgery of the tarsal tunnel: a novel technique for the proximal tarsal tunnel syndrome-Part II. Surg Radiol Anat 41,1:43-51
- Moroni S, Zwierzina M, Starke V, et al. (2019) Clinical-anatomic mapping of the tarsal tunnel with regard to Baxter's neuropathy in recalcitrant heel pain syndrome: partI. Surg Radiol Anat 41,1:29-41Dicussion: You must take in account the paper publish in SRA part I,II,(III is quoted)

THE TARSAL TUNNEL – ULTRASOUND-GUIDED ANKLE AND FOOT
DECOMPRESSION SURGERY (UGAFDS) – A MINIMALLY INVASIVE APPROACH
WITH REGARD TO THE PROXIMAL TARSAL TUNNEL SYNDROME
- Fernandez-Gibello A, Moroni S, Camunas G, et al. (2019) Ultrasound-guided decompression surgery of the tarsal tunnel: a novel technique for the proximal tarsal tunnel syndrome-Part II. Surg Radiol Anat 41,1:43-51
- Moroni S, Zwierzina M, Starke V, et al. (2019) Clinical-anatomic mapping of the tarsal tunnel with regard to Baxter's neuropathy in recalcitrant heel pain syndrome: partI. Surg Radiol Anat 41,1:29-41Authors’ comment – We added the introduction revision and reference according to the reviewer's opinion.

 

Reviewer’s comment – Regarding the methodology, I consider that it is well structured . However, the statistical analysis should be better described, because the authors use a statistic applied to surveys, however, it is not described in the methodology itself. Therefore, please indicate which statistic was used to obtain the P, and the level of significance.

Authors’ comment – We described the statistical analysis method and significance level according to reviewer's opinion.

 

Reviewer’s comment – With regard to the discussion, it is well organized and I consider it is a strength of your work. However, you should add more bibliographic citations. Besides, I would recommend to be more specific in the limitations of the study due to the population used is school children. Therefore, it is not representative of taekwondo across a broad spectrum of competitions and ages.

Authors’ comment – We have added and described the limitations according to the reviewer's opinion..

 

Reviewer’s comment – Finally, the conclusion is shorter. Note, the main point is missing, being that the incidence of injuries is produced mainly by injuries without opponent, or in training situations. On the other hand, I consider the final recommendation by the authors right.

Authors’ comment – The conclusion was added and described according to the reviewer's opinion.

 

Reviewer’s comment – 31-31 Rephrase the sentence for a better understanding

32 and 35 put a space between the name and the year of the quotation.

40-42 Rephrase the sentence and add a reference

51 Add a bibliographic reference

59 Rephrase the sentence since the authors indicated several and only referenced 1. Therefore, classify the cited reference better.

Authors’ comment – All of the above has been added and modified according to the reviewer's opinion.

 

Sincerely yours

Email: [email protected]

Round 2

Reviewer 1 Report

1. The authors still indicate that they used random sampling to select the 500 participants from a possible 3000 athletes but do not indicate how the random selection occurred.  If questionnaires were provided to 3000 potenttial participants responded, this is not random sampling.
2. Injury by person should be defined as one where the athlete imparts an impact on the opponent and injures their limb or when the opponent contacts the athlete and causes an injury.
3. Non contact injury should be defined as an injury that occurs when the mechanism of injury does not involve contact with the opponent such as when they invert the ankle or rotate the knee in weight bearing.
4. Re-injury should be defined where the athlete reports that there was a history of a previous injury that preceded this one.  The data indicates that there are as many as 83% of injuries are a recurrence of injury which should be discussed as significant variable and recommendation for prevention of injury.
5. Frequency tables:  I don't understand why the injuries during practice and injuries during competition are more than the injury experience (N)
6. "In addition, national Taekwondo athletes (mostly adults) are reported to sustain several injuries in the lower extremities, including the ankles, knees, and thighs (Park & Song, 2018); however, high school athletes are reported to injure the knees first, followed by the thighs and ankles. Therefore, sports injuries may be directly associated with the careers of the athletes, but further research is warranted to determine the exact correlation."  This statement still does not make any sense.  it says that adults have lower extremity injuries (knee, thigh and ankles) and so do the hight school athletes in the study.   Should It say that adults have more injuries in ankles; then knees; then thighs?
7. "In a previous study, the incidence of chronic pain in athletes with an injury history was reported to be 66.7%"  Are the authors implying that chronic pain is the same as recurring injuries?
8. I unfortunately do not feel that this research provides us with much information that can direct any preventative strategies as being expressed by the authors.

Author Response

Dear Editor and reviewers

 

We are grateful for the positive feedback we have received from the editors and reviewers of Applied Sciences. We were elated to find that other experts have acknowledged the clinical significance of our manuscript and we feel indebted for the editors and reviewers for sharing their valuable opinions to upgrade the overall academic value of this paper.

We have given full consideration to the comments made by each reviewer and have reflected their opinions in the manuscript. The following are the responses we have made for each comment made by the editors and reviewers.

Author Response File: Author Response.docx

Round 3

Reviewer 1 Report

See comments in attached.

Comments for author File: Comments.pdf

Author Response

First of all, we are very delighted and thankful that through 3 comments our research is improving. We followed the reviewer’s comment and edited the paper. We wish our revision addresses all the comments and we wish to publish this paper is published at your journal.

Author Response File: Author Response.docx