School Scoliosis Screening: The Influence of Dominant Limbs and Gender

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Overall, it is a good paper and well-written. The Introduction adequately addresses the scientific literature. The authors describe the statistical methods thoroughly, and the results are straight to the point with discussion.

 

I recommend the authors revise the paper to ensure that acronyms are correctly introduced. As an example, the abstract lacks the definition of ATRA and ATRB. It may be common knowledge for specialists but not for all paediatricians and other health professionals interested in reading the paper. Further, the authors define the acronym ART in the Abstract but not in the paper when it is first mentioned in the Introduction (line 66). Thus, acronyms need to be checked throughout and revised as needed.

 

Another issue is the sample and how it was collected. The authors describe the process of engaging the schools and parents. Nevertheless, there is no information on how many letters (emails?) were sent to parents and if anyone denied their children’s participation. Further, did any of the adolescents deny participating despite parental approval? Thus, the discussion might be appropriate on whether parental approval was necessary for all the children, as children have the right to express their opinions and participate in matters of concern to them, in line with the Convention on Children’s Rights (CRC). This aspect should merit some consideration.

 

The third issue is that the authors selected the population from private schools in Cyprus; how many schools with potential participants? What age groups were targeted (average age 14 +/-3 years for boys and 14 +/-2 years for girls, without one decimal, which I would recommend)? As these are children in secondary schools, some children were 11-12 years of age, and the oldest was 16-17. What is the target age to attend secondary school in Cyprus, or what is the target age group for the study? The selection of students in private schools compared to public schools would also merit discussion, at least in the Limitation section, as these might be two different populations with different socioeconomic backgrounds and experiences of scoliosis. The population sample should also be described in the Abstract.

 

Please note inappropriate dashes in lines 36-37.

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This is an interesting concept but without graphics, it is confusing for the reader to determine exactly the curve that is mentioned and how each relates.  Recommend addition of pictures with measurements and abbreviations to assist the reader's comprehension.

Please be sure all abbreviations are explained prior to using them (abstract ATRA)

Study limitations are accurately and adequately described.  The conclusions appear to outreach the findings.  Suggesting that involvement in sport might contribute to some of the cross-lateralization in boys may be warranted but going further to suggest modifications that might be made based on that assumption is unwarranted particularly since the incidence and effect sizes were small.  It is unclear if the girls in the study were exempt from playing soccer or not? 

Several of the references do not appear to be necessary for the study. 

 

 

Comments on the Quality of English Language

There are a few awkward word choices:

lines 52 & 248"pre-existed" should be "pre-existing"

line 75 - "school's settings" should be "school settings"

line 109 - the term "closed feet" is confusing

The sentence in lines 249-251 is confusing and needs to be reworded

Author Response

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Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

Introduction

Coment 1 Studies have shown that depression is associated with numerous mental and physical problems. The introduction should be expanded to include problems related to the dominant or non-dominant side of the body.

Method

Line 100-103

Mturity data were collected based on the answers of a questionnaire sent to parents regarding their children’s biological maturation; where for girls was the onset of their menstrual and for boys’ was the pubic hair growth [25].

 [16].

Coment 2 Since these data were not further analyzed or discussed, I consider them superfluous in this paper.

Line 122-125

Laterality has been defined as the advantage of one side of the body in respects to usability, precision, and coordination [28]. Laterality progressively develops with age and is established around the age of 7 years old [28,29]. Each student reported his/ her dominant hand as the one using for writing and the dominant leg as the one using to kick a ball.

Coment  3. Although the limitations of the study state that the dominant side was not measured, this part can be expanded. Studies looking at the dominant side of the body are increasingly looking at the degree of dominance and not just the dominant side. Writing is a fine motor skill and kicking is a gross motor skill. There is another problem: all people write but does everyone play football (especially girls)?

Author Response

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Author Response File: Author Response.pdf