Author s response to reviews Title: Eye movements in patients with Whiplash Associated Disorders: a systematic review Authors: Britta K Ischebeck (bischebeck@sjcn.nl;b.ischebeck@erasmusmc.nl) Jurryt de Vries (j.devries.3@erasmusmc.nl) Jos N. van der Geest (j.vandergeest@erasmusmc.nl) Malou Janssen (m.janssen.1@erasmusmc.nl) Jan Paul van Wingerden (jpvanwingerden@sjcn.nl) Gert-Jan Kleinrensink (g.kleinrensink@erasmusmc.nl) Maarten A Frens (m.frens@erasmusmc.nl) Version: 2 Date: 13 Sep 2016 Author s response to reviews: BMSD-D-16-00545 Eye movements in patients with Whiplash Associated Disorders: a systematic review Britta Ischebeck, MSc; Jurryt de Vries, MSc; Jos van der Geest, PhD; Malou Janssen, MSc; Jan- Paul van Wingerden, PhD; Gert-Jan Kleinrensink, PhD; Maarten Frens, PhD BMC Musculoskeletal Disorders Dear editor and reviewer, Thank you sincerely for your useful response and the opportunity to publish a revised version of our paper in BMC Musculoskeletal Disorders.
We have modified the paper in response to the comments and hope that the paper is further improved. We will respond to the comments point by point. We hope you will consider the revised manuscript for publication in your journal. On behalf of all authors, yours sincerely, Britta Ischebeck phd candidate, Erasmus MC, Rotterdam, The Netherlands Point to point reply to reviewer s remarks p.11, line 41 should delete this last sentence as SP is different to SPNT. SPNT compares the difference between neutral and torsion and thus if other tests using SPNT have found differences at 20 degrees per second then probably this should be used. REPLY: As suggested, we deleted the mentioned sentence. p.13, line 57 either add relatively rotated or torsioned position REPLY: We changed in the whole paper rotated position into relatively rotated position. p. 14, line 6 they did not exclude saccades
REPLY: We specified the sentence and write now that Tjell et al and Treleaven et al did not exclude saccades in their analysis, Janssen et al. did exclude saccades. p.14, line 9 in the later 3 studies REPLY: We now write in the later 3 studies. p.14, line 12 is this correct? REPLY: We checked the three studies again carefully and adapted the information. Two studies analysed the data fully- automated and one study did not provide information over the exact analysis. p.15, line 6 relative neck rotation or torsioned position REPLY: As already above mentioned, we checked in the whole paper rotated position into relatively rotated position. p. 15, line 24 this last sentence is not needed, mentioned above. REPLY: We deleted the mentioned sentence. p.17, line 16 I think this sentence should be removed, the tests measure different things. REPLY: We removed the sentence.
p.18, line 42 Think this sentence should be removed unless say why, if it is related to lack of association to other factors then other tests haven t done that either. REPLY: We agree with the reviewer that in all three different methods insufficient attention is paid to possible associations with other factors. However, we want to point out that until the used analysis is further developed, the SPNT test has to be used carefully. To avoid misunderstandings, we changed the position of the sentence, referring now directly to the way of analysis. p.19, line 27 whilst I agree, I don t think the review has encompassed enough detail to come to this conclusion. I would remove this statement. REPLY: As suggested, we removed the statement. p.19, line 57 grammar, sentence should be rewritten REPLY: We rewrote the sentence. p.20, line 4 add neck torsion I would add though that this has the best potential for differential diagnosis compared to eye head coo-ordination. REPLY: We specified smooth pursuit method into smooth pursuit neck torsion test and mention that the SPNT test has the best potential for differential diagnosis compared to eye head coordination.
p.20, line 44 again grammar. REPLY: We corrected the sentence. p.20, line 49 Is there a reason that these papers were not included in this review - looked at SPNT WAD, controls and vestibular patients. Treleaven J, LowChoy N, Darnell R, Panizza B, Brown-Rothwell D, Jull G. Comparison of sensorimotor disturbance between subjects with persistent whiplash-associated disorder and subjects with vestibular pathology associated with acoustic neuroma. Arch. Phys. Med. Rehabil. 2008;89(3):522-530. as well as 2. Treleaven J, Clamaron-Cheers C, Jull G. Does the region of pain influence the presence of sensorimotor disturbances in neck pain disorders? Man. Ther. 2011;16(6):636-640. REPLY: The study Does the region of pain influence the presence of sensorimotor disturbances in neck pain disorders? was not included because it did not fulfil all inclusion criteria (healthy control group). That we did not include the study Comparison of sensorimotor disturbance between subjects with persistent whiplash-associated disorder and subjects with vestibular pathology associated with acoustic neuroma was missed accidentally during the screening process of the titles. We apologize for the incompleteness and want to thank the reviewer for her important observation. Both studies are now included into the review. The first study is excluded during the screening process. The second study belongs to the fourteen included studies and is carefully reviewed. p.24, line 2 torsion rather than rotation should be used throughout REPLY: We changed in the whole table torsion into rotation. p.24, line 22 this is confusing rotation here refers to the direction of the eyes not torsion position REPLY: We changed the information into right/ left rotation of the eyes.