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Thank for your second minor revision in your manuscript.
Your manuscript have been revised by 3 of the 4 original reviewers and they are recommending its acceptance pending minor revision.
The introduction section was improved with concepts of etymology and posturography being clarified, which is better than the first version.
The authors have performed a sample size calculation to justify their data. This is noted in the section of Material and Methods.
New references were included to better support their findings. The study remains robust and statistically sound.
Overall, this version of the manuscript is significantly better than the previous one.
Table 1, please add percentage after each frequency
Table 2, Please spell out BMI and add unit for BMI
No issue
The results are valid
The authors have made necessary amendments.
The manuscript is written correctly.
Professional article structure, figures, tables. Raw data shared.
Original primary research within Aims and Scope of the journal.
The research question has been well defined and the reason why it is necessary is specified.
Rigorous research carried out with a high technical and ethical standard.
The proper use of the instrument and its reliability with the iCC and SEM study is justified
3. Validity of the Findings
The results are appropriate to the conclusions obtained and the research question asked
Adequate references that justify the knowledge on which the research is based.
Dear authors;
The manuscript has improved its writing quality and is more concise. Some items can still be improved
Introducción
The introduction is very long, try to reduce it if possible.
Material and Methods
Try to put the exclusion and inclusion criteria in a more visible way, separate from the previous paragraph.
Please explain the instructions that the subjects were given to perform the test, where they were instructed to place their feet, etc.
Results
This section is correctly done
Discussion
This section is correctly done
Conclusions
Please retire line 549, it is not necessary to detail possible research futures in conclusions
Your manuscript has now been reviewed by 4 independent reviewers. Based on their comments I invite you to revise your manuscript but note that at this point I cannot guarantee the acceptance of a revised version of your study. Particularly, reviewer 2 and 4 raised several critical points that you have to consider. For instance, the statement text is deficient in basic concepts on static posturography and vestibular control of posture needs special attention. Reviewer 2 and 4 also indicate some studies that are germane to your study. To facilitate the reviewer of your revised manuscript, clearly indicate in the rebuttal letter where you have introduced the changes to address the questions raised by the reviewers (page, lines, etc).
[# PeerJ Staff Note: It is PeerJ policy that additional references suggested during the peer-review process should only be included if the authors are in agreement that they are relevant and useful #]
[# PeerJ Staff Note: Please ensure that all review comments are addressed in a rebuttal letter and any edits or clarifications mentioned in the letter are also inserted into the revised manuscript where appropriate. It is a common mistake to address reviewer questions in the rebuttal letter but not in the revised manuscript. If a reviewer raised a question then your readers will probably have the same question so you should ensure that the manuscript can stand alone without the rebuttal letter. Directions on how to prepare a rebuttal letter can be found at: https://peerj.com/benefits/academic-rebuttal-letters/ #]
[# PeerJ Staff Note: The review process has identified that the English language must be improved. PeerJ can provide language editing services - please contact us at copyediting@peerj.com for pricing (be sure to provide your manuscript number and title) #]
The article is well written. English is clear. References are properly cited. Figures and tables are well organized. The collection of the data are provided in detail.
Ethical approval and patient consent in the original Spanish language were also made available as supplemental files.
In the introduction, I suggest you organize the rationale of the proposed method according to the sequence of the three stages of the MCQ-balance assessment you choose.
You aim to evaluate the effectiveness of your proposed 3 stages assessment method by comparing with the results of clinicians’ performance in discerning the altered BSS and assessing its progression. The research objective is well defined. The experimental design is original. The results are relevant and meaningful. It provides clinically interpretable and objective information.
This study has some degree of novelty in terms of the method proposed to facilitate monitoring patient balance and providing information that could improve clinical decision making. The comparison between the MCQ-Balance assessment and the evaluation of the clinician is well presented. The data are robust, statistically sound, and well-controlled.
I commend the authors for the extensive data set, well-designed figures, and tables.
This is a poorly written manuscript. The authors have limited concepts on static posturography, vestibular control of posture, and research. The paper has signs of ignorance. Authors do not know even the literature on the subject. Finally, their English language is too poor for scientific paper.
Very poor! The authors' selection of posturographic metrics is unacceptable. They should also know that the results of static posturography are strongly biased by subjects' age and comparisons with a 1-month period between "pre" and "post" have no sense is such a diverse group.
None.
The Authors should start their scientific adventure with fundamentals of static posturography e.g., Reymakers et al. 2004 or Blaszczyk 2016. Simple comparisons of unreliable parameters do not make any sense.
no comment- but the introduction was rather too long
no comment
no comment
Overall
This study is conducted to test the reliability of MCQ-balance test to quantify the progress of patient with vertigo symptoms which was usually assessed by the Clinician. The study found that MCQ-balance has high accuracy and reliable with clinical judgement as the reference. The research team did a good work on simplifying the outcome of postrography test which is usually huge.
Introduction
The introduction was rather long, I would suggest the author to make it more concise and highlight more on the importance of having a more objective measure.
In the (first paragraph), author was focusing on the harm of vertigo on Older people. But the sample was in the age range of 35 to 70 with mean 50+ years old. Perhaps Author should emphasize the impact of vertigo on the young adult population as well.
Please be consistent to use abbreviation for centre of pressure (COP)line 92 or (CoP) line 213
Method
The methodology was technically sound
Results
TABLE 2: This study did not compare between peripheral deficit and central deficit groups, thus I cannot see the rationale to describe the participants according to their type of deficit. Can just describe them as a whole and add row to report on their type of deficit
Discussion
Author should discuss the limitation of the usage of this technique in economy angle as well, knowing that not all hospital or healthcare provider can afford to buy proper posturography machine especially in low and middle income countries.
Conclusion
In the conclusion authors should add their recommendation to automate the scoring system by incorporating Artificial intelligence/machine learning technology
The manuscript is written correctly but should be written in a more direct language. Use shorter sentences and thus be able to reduce the number of words in the article and facilitate understanding.
Professional article structure, figures, tables. Raw data shared.
Original primary research within Aims and Scope of the journal.
Research question needs to be defined in a more concrete way, if the situation arises from which researchers consider necessary an equilibrium exploration in an objective way but must define their research question and hypothesis.
Rigorous research carried out with a high technical and ethical standard.
Methods described in sufficient detail and information to replicate. They only need to be more specific in their explanation.
The results are solid in demonstrating the ability to establish an equilibrium pressure platform assessment that can be used clinically to assess equilibrium status and progression. It is a novel aspect. Although the amount of data required seems to put a negative point on its actual use in the clinic.
Adequate references that justify the knowledge on which the research is based.
The conclusions are well established, linked to the original research question. But they need to be more concise and concrete and a better wording.
Dear authors;
The manuscript is written correctly but should be written in a more direct language. Use shorter sentences and thus be able to reduce the number of words in the article and facilitate understanding.
The research is interesting but it must modify to include certain important information and reduce secondary information.
Abstract
Subheadings are missing as indicated in the journal authors instructions (background, material and methods reuslts and conclusion.
Line 26. Delete “and of this group”. Better simple phrases. Put point after episode and add 20% of them do not recive ...Where are the keywords? And abbreviations?
Introducción
Line 69-71. It should better explain whether the alteration of balance due to cervialgia is of central origin or not, or this consideration depends on the criteria of different authors.
Line 75 to 81. This paragraph is thus summarized and clarified by saying that the equilibrium system can be altered by one or in combination of the three systems BBS VS and ES AND PS. A simple trauma can affect them, so protocolize an initial evaluation and progression method is necessary.
Line 83 to 89. Explain in fewer words.
Line 91 to 127. Explain the positive and negative aspects of posturology with fewer words.
Line 128 to 135. Explain this paragraph in fewer sentences.
Line 136 to 148. Explain the reason why the MCQ-Balance is chosen, if it is the best in what sense with respect to the negative aspects of the use of the posturology that you have listed. Do not explain the protocol or the number of subjects, you will do so in material and methods. Explain the purpose of the study, and the hypothesis.
Material and Methods
Line 152. Subheading name “Participants” better than participants and ethic statement.
Line 153. Eliminate “in the present work.”
How many men and women formed the sample? Of what ages and demographic characteristics? Cite table 2 but show it at results section.
Lines 153 to 167. Is possible reduce the words?
Explain the reason to select heterogeneous patients with central or peripheral origin or diagnosis method of vertigo. If you think it could be a limitation include this in a discussion section please.
Lines 177 to 179. Is important to th research these tests? Explain or delete.
Lines 181 to 185. Why have you select these exclusion criteria? Could you add a reference that uses them? Why do you not excluded auditive deficits or chirurgical process in the last 1 year?
Lines 186 to 198 must be explained at material and methods.
Lines 199 to 202. Explain if they follow the Declaration on the Human Genome and Human Rights and the Declaration of Helsinki criteria. If so add the reference.
Is this study registered in clinical trials? Contribution number of said registry.
Provide the calculation of the sample size to justify that the data obtained with said sample are sufficient to carry out said investigation and include it in this section.
Subheading Instrumentation, better to separate it from protocol and variables
Line 209 and 210. Write down main quality characteristics, for example number of sensors per area and total recording area. Indicate a reference where there is a reliability study of the platform if it exists and if it does not exist indicate it.
Line 212-2014 This part of the data processing is more indicated to name later.
Line 216 to 234. Reduce the sentences to give this information.
Subheading Portocol
Line 234 to 268: explain the protocol that was carried out after the subjects signed the consent, briefly and concisely in chronological order.
Also explain what instructions were given to the subjects. IF the process was explained to them or not, if they performed any tests to familiarize themselves with the procedure, if the order of the foam rubber conditions was randomized, etc. Was only one record made for each condition? Because the MCQ-Balance assessment method was followed and no other.
Were the subjects told to position their feet in a certain way as shown in figure 1? As in other platform balance studies like this one? If the answer is, do not justify the reason. If so, explain in addition to showing the figure and attach reference.
Martínez-Jiménez E, Losa-Iglesias M, Díaz-Velázquez J, Becerro-De-Bengoa-Vallejo R, Palomo López P, Calvo-Lobo C, et al. Acute Effects of Intermittent Versus Continuous Bilateral Ankle Plantar Flexor Static Stretching on Postural Sway and Plantar Pressures: A Randomized Clinical Trial. J Clin Med [Internet]. 2019 Jan 7 [cited 2019 Jan 27];8(1):52. Available from: http://www.mdpi.com/2077-0383/8/1/52
Explain why it was compared with the clinical criterion in the last phase and not with a more objective criterion such as the Balance Assessment Systems (BESTest) test? Justify that the functional assessment made by the clinician is adequate. What clinical tests were performed? Were they reliable?
Padgett PK, Jacobs JV, Kasser SL. Is the BESTest at its best? A suggested brief version based on interrater reliability, validity, internal consistency, and theoretical construct. Phys Ther 012;92: 1197-207.
Lines 272 to 389 reduce the number of words in this section as much as possible.
Define each variable and the units of measurement used briefly and concisely.
Explain here if any variable is more relevant than another according to the reference studies.
Line 399 How much experience did the clinician have performing this task?
Line 402 Explain first the tests that were carried out for the assessment by the clinician and then the 3 categories.
Create a subheading statistical analysis
Lines 416 to 418 should not be in this section. Include in statistical analysis
Lines 421 to 425 Insert references in these statements.
Results
Line 428. This phrase is not required. Correct the next sentence on line 429 when removing it
Discussion
It is an excessively long section, try to reduce the words expressing the same information
Lines 478 to 480. Summarize in a general way your results in one sentence and then say if you have served the purpose of the study with these results. Don't explain the MCQ balance method again.
What do you think of the reliability obtained, could it be improved? Infer and speculate making it clear that it is a belief and not a statement.
In your opinion, infer the determining study variable.
Please, presents possibilities or inferences to be able to systematize its performance in the clinic, infer in possible future investigations.
Line 556 This is a study limitation that should be reflected at the end of the discussion. Another is age, which was not delimited in the sample and is directly related to balance, include the limitations you consider and name them as such. Don't you think that precision is lost when converting continuous quantitative variables into qualitative ones?
Lines 563 to 573 explain it in fewer words, name it without depth.
Conclusions
Please 3 or 4 sentences only without data without percentages or data, only the statement we arrived at with the research.
Tables. Improve the legend that explains the data represented in the tables and the format.
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