Virtual Reality Gaming in Rehabilitation after Musculoskeletal Injury—User Experience Pilot Study

Round 1

Reviewer 1 Report

Musculoskeletal injuries are a very important issue in terms of sports rehabilitation.

VR games/technologies have started to be used in sports rehabilitation as in many areas.

The study is a pilot study conducted to serve this purpose. A well-constructed work. Congratulations.

Injuries in elite football players are not as common as amateur football players. In particular, the development of the players physical capacity, the development of technical skills, the presence of individual characteristics in the musculoskeletal system and physical fitness can reduce the risk of injury.

However, injuries are very common in amateur football players. Although this study has not been done on football players, I think that it can be an option and can be applied for amateur football players. I think that it can create an awareness in preventing injuries especially when amateur football players start playing football.

 

Materials and Methods

The characteristics of the individuals participating in the study are given.

But do these  participants   have football-related connections?

How long have they been playing football?

Have they ever played football?

I think it would be good to give information about them.

 

Discussion

I think that the results obtained for the participants were not sufficiently discussed in the discussion.

There should be explanations in the discussion about the assessment and evaluation explained in the Method section and made to the participants. No mention of tests and scales. I think this is important in terms of results.

Author Response

Dear Reviewer

Thank you for the opportunity to revise our manuscript (Applsci-2125615) and resubmit it to Applied Sciences.

We are very grateful for the overall positive evaluation and detailed and helpful suggestions for improvement. We have addressed all the comments raised in a thorough revision and feel that the manuscript has improved substantially.

We hope the revised version is suitable for publication in the Applied Sciences

Comments:
Musculoskeletal injuries are a very important issue in terms of sports rehabilitation.

VR games/technologies have started to be used in sports rehabilitation as in many areas.

The study is a pilot study conducted to serve this purpose. A well-constructed work. Congratulations.

Injuries in elite football players are not as common as amateur football players. In particular, the development of the players physical capacity, the development of technical skills, the presence of individual characteristics in the musculoskeletal system and physical fitness can reduce the risk of injury.

However, injuries are very common in amateur football players. Although this study has not been done on football players, I think that it can be an option and can be applied for amateur football players. I think that it can create an awareness in preventing injuries especially when amateur football players start playing football.

1. Answer: We totally agree with the reviewer. We have included across the manuscript the idea that limited data are available for elite or amateur soccer players and reinforced that we also consider amateur soccer

Materials and Methods

The characteristics of the individuals participating in the study are given. But do these  participants   have football-related connections? How long have they been playing football? Have they ever played football? I think it would be good to give information about them.

2. Answer: we agree with the reviewer about the lacking information on the participants' experience with soccer. Unfortunately, we don’t have such information. However, to clarify, we assumed in the limitations section, the students recruited at the academic institution involved in this user experience pilot study differ from elite or amateur soccer players, where this solution may be implemented. We only consider the following inclusion criteria for these studies: (1) students aged 18 years or older from an academic institute; (2) voluntary motivation to participate in the study. We did not control if participants had football-related connections. We considered, in addition, this limitation in the discussion. 

Discussion

I think that the results obtained for the participants were not sufficiently discussed in the discussion. There should be explanations in the discussion about the assessment and evaluation explained in the Method section and made to the participants. No mention of tests and scales. I think this is important in terms of results.

3. Answer: Several edits were made across the discussion section to overcome these fragilities.

Reviewer 2 Report

First of all, thank you for allowing me to review this very interesting manuscript.

Here are some recommendations:

Introduction

-from line 47 to line 50 there are two statements without any reference. Please look for bibliography to support these assertions.

-The same applies from line 56 to line 60. Please cite literature that supports the information included in the introduction.

-The same issue occurs from line 68 to 73.

-Please note that the first objective described in the abstract and the one described in the introduction are not understood as the same, one refers to implementation and the other to description. Please rewrite one of them so that they are similar.

Methods

- In the Software and Hardware subsection, I understand that the 3 "trackers" are placed on the user's feet and waist but it is not absolutely clear. Please clarify this issue in the text.

- The methods are very well written and it is clear the procedure to be followed in the proposed research. Congratulations

Results

-The first column of Table 2 shows presentation errors.

-What is the difference between the variables shown in Table 3? I understand that the quality of the execution and the score obtained after finishing the game are the same or dependent. Please clarify in the Methods section.

-From line 343 to 355 the interpretations of Figures 1 and 2 are written. It would be advisable to present the figure and later the explanation of the same, instead of the two explanations and then the two figures.

- Figure names should not be completely bolded.

Discussion

- Touloudi et al. (2022) is not in the correct citation format, as the citation should appear after the name of the researcher and not at the end of the sentence.

Conclusions

- The conclusions are well written

 

Author Response

Dear Reviewer

Thank you for the opportunity to revise our manuscript (Applsci-2125615) and resubmit it to Applied Sciences.

We are very grateful for the overall positive evaluation and detailed and helpful suggestions for improvement. We have addressed all the comments raised in a thorough revision and feel that the manuscript has improved substantially.

We hope the revised version is suitable for publication in the Applied Sciences

Comments:

First of all, thank you for allowing me to review this very interesting manuscript.

Here are some recommendations:

Introduction

-from line 47 to line 50 there are two statements without any reference. Please look for bibliography to support these assertions.

1. Answer: The reviewer is right. The following references were added:

• Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Rollnick, S., Edwards, A., & Barry, M. (2012). Shared decision making: a model for clinical practice. Journal of general internal medicine, 27(10), 1361–1367. https://doi.org/10.1007/s11606-012-2077-6
• Putukian M. (2016). The psychological response to injury in student athletes: a narrative review with a focus on mental health. British journal of sports medicine, 50(3), 145–148. https://doi.org/10.1136/bjsports-2015-095586

-The same applies from line 56 to line 60. Please cite literature that supports the information included in the introduction.

2. Answer: The following references were added:

• Gouveia, É. R., Smailagic, A., Ihle, A., Marques, A., Gouveia, B. R., Cameirão, M., Sousa, H., Kliegel, M., & Siewiorek, D. (2021). The Efficacy of a Multicomponent Functional Fitness Program Based on Exergaming on Cognitive Functioning of Healthy Older Adults: A Randomized Controlled Trial. Journal of aging and physical activity, 29(4), 586–594. https://doi.org/10.1123/japa.2020-0083
• Park, M. J., Kim, D. J., Lee, U., Na, E. J., & Jeon, H. J. (2019). A Literature Overview of Virtual Reality (VR) in Treatment of Psychiatric Disorders: Recent Advances and Limitations. Frontiers in psychiatry, 10, 505. https://doi.org/10.3389/fpsyt.2019.00505

-The same issue occurs from line 68 to 73.

3. Answer: The following references were added:

• Stafford, J.; Williams, N.; Johnson, A.; White, D.; Craig, C. An Evaluation of a Low-Cost Virtual Reality Rehabilitation Tool in an Elite Soccer Environment. Open Acess J Biog Sci Res 2022, doi:10.46718/JBGSR.2022.10.000266.
• Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Rollnick, S., Edwards, A., & Barry, M. (2012). Shared decision making: a model for clinical practice. Journal of general internal medicine, 27(10), 1361–1367. https://doi.org/10.1007/s11606-012-2077-6

 

-Please note that the first objective described in the abstract and the one described in the introduction are not understood as the same, one refers to implementation and the other to description. Please rewrite one of them so that they are similar.

4. Answer: according to the recommendation, the objective was rewritten.

Methods

- In the Software and Hardware subsection, I understand that the 3 "trackers" are placed on the user's feet and waist but it is not absolutely clear. Please clarify this issue in the text.

5. Answer: according to the recommendation, the information was clarified in the text.

- The methods are very well written and it is clear the procedure to be followed in the proposed research. Congratulations

6. Answer: thanks to the reviewer for the positive feedback.

Results

-The first column of Table 2 shows presentation errors.

7. Answer: The error was corrected;

-What is the difference between the variables shown in Table 3? I understand that the quality of the execution and the score obtained after finishing the game are the same or dependent. Please clarify in the Methods section.

8. Answer: Additional information was added to clarify.

-From line 343 to 355 the interpretations of Figures 1 and 2 are written. It would be advisable to present the figure and later the explanation of the same, instead of the two explanations and then the two figures.

9. Answer: we followed the recommendation of the reviewer.

- Figure names should not be completely bolded.

10. Answer: we followed the recommendation of the reviewer.

Discussion

- Touloudi et al. (2022) is not in the correct citation format, as the citation should appear after the name of the researcher and not at the end of the sentence.

11. Answer: we followed the recommendation of the reviewer, and corrected this accordingly.

Conclusions

- The conclusions are well written

12. Answer: thanks to the reviewer for the positive feedback.

Reviewer 3 Report

Point 1: In the paper there “Recent studies developed in the sport context have reported” please reference the studies and describe their ideas in detail as literature review.

Point 2: In the paper there is no any literature review to support your idea, References are not enough to support your idea, more references is needed preferred from the last 5 years specially that contain a VR system used for rehabilitation purpose.

Point 3: In section “2.3 Quality of the movement assessment” could you please clarify that if the scoring system have an effect on the participant weather the lower score have negative effect of the tasks.

Point4:  Line 201” Until today, HTC Vive is the most efficient system for a complete tracking experience, 201 using trackers alongside the controllers and the headset” please add the reference and mention the other systems names.

 

Point5:  English language and style issues, need to be corrected.  

Author Response

Dear Reviewer

Thank you for the opportunity to revise our manuscript (Applsci-2125615) and resubmit it to Applied Sciences.

We are very grateful for the overall positive evaluation and detailed and helpful suggestions for improvement. We have addressed all the comments raised in a thorough revision and feel that the manuscript has improved substantially.

We hope the revised version is suitable for publication in the Applied Sciences

Comments:

Point 1: In the paper there “Recent studies developed in the sport context have reported” please reference the studies and describe their ideas in detail as literature review. 

1. Answer: Additional references were added to the text. However, we are trying to underline in this section of the introduction that, the studies developed by Gumaa et al., 2019; Stafford et al., 2022; and Vogt et al., 2019; support that virtual reality is effective in orthopedic rehabilitation as well as in balance prevention and rehabilitation after musculoskeletal. Also, this reinforces the use of this system in a Soccer Environment.

Point 2: In the paper there is no any literature review to support your idea, References are not enough to support your idea, more references is needed preferred from the last 5 years specially that contain a VR system used for rehabilitation purpose. 

2. Answer: Several references were added to the text.

Point 3: In section “2.3 Quality of the movement assessment” could you please clarify that if the scoring system have an effect on the participant weather the lower score have negative effect of the tasks. 

3. Answer: If the end-user does not perform correctly, he loses points and receives audio feedback. This information was added in this section.

Point 4:  Line 201” Until today, HTC Vive is the most efficient system for a complete tracking experience, 201 using trackers alongside the controllers and the headset” please add the reference and mention the other systems names. 

4. Answer: we decided to delete this information: “Until today, HTC Vive is the most efficient system for a complete tracking experience, using trackers alongside the controllers and the headset”.

Point 5:  English language and style issues, need to be corrected.

5. Answer: Several edits were made across the text.

Round 2

Reviewer 3 Report

The authors answered my previous questions well.