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| Please add your signature at the end of your comments (to do this click on 'wikitext' in the editing toolbar and add <nowiki>~~~~</nowiki> at the end of your comment). | | Please add your signature at the end of your comments (to do this click on 'wikitext' in the editing toolbar and add <nowiki>~~~~</nowiki> at the end of your comment). |
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| == Peer Review by Physical Therapy Journal ==
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| Thank you for submitting your paper to PTJ. We have now completed our review.
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| After reading the paper and considering the Reviewers’ comments, I find myself largely in agreement with the Reviewers' assessments, and I therefore have regretfully concluded that PTJ cannot accept your manuscript for publication. Although there is potential for this manuscript to increase awareness of mental health issues, there are many major concerns with the way it is currently being presented to readers of PTJ. Below I will summarize main points that led to the decision on this manuscript:
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| *The case report is written in an unscholarly manner, including use of imprecise language and lack of distinction between mental health and substance abuse disorders. As a result, this case report would not provide a meaningful contribution to the physical therapy literature. This point was reinforced by both Reviewers, who provided specific examples for you. <br>
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| *There is an indication of patient consent due to “intriguing factor of his mental health comorbidity – page 4” but there was also apparently a “post-hoc” component to this case reporte as indicated on page 5 (“the therapist, unaware of the impact of the co-occuring disorder…”). This sequencing for selection of the patient is extremely confusing (best case scenario) and potentially unethical (worst case scenario). <br>
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| *One potential area of strength for this manuscript was to increase awareness of mental health/substance abuse and/or provide a model for physical therapist practice. However, neither of these goals was met for all the reasons highlighted by Reviewers #1 and #2. Another potential strength was for this to be a paper of “what not to do” (Reviewer #2), but the paper was not presented in that fashion so it cannot serve as a learning lesson. <br>
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| *One of the potentially novel components of the case (motivational interview) was extremely underdeveloped. A classic example of the cursory coverage of MI is provided on page 10 (“MI was used to help him find several solutions”). Another important component (adherence) was also underdeveloped – see comments from Reviewer #1. <br>
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| *I agree with Reviewer #2 that the emphasis on manual therapy for this low-grade musculoskeletal problem was unwarranted; and, even if it HAD been warranted, there was too much reliance on unsubstantiated measures for this case to be a useful description of patient management. This case should have focused on the early detection and referral, not on primary management by a physical therapist. <br>
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