Effects of Line Dancing on Mental Health in Seniors after COVID-19 Pandemic

Round 1

Reviewer 1 Report

Dear, Authors. Thank you for your important work on the use of line dancing related to mental health in a geriatric population. I was excited to review your article, and I hope that you consider the following suggestions to improve your manuscript.

1. You frequently use the word "blockage" related to the COVID-19 pandemic. I believe there is a different term that might contextual fit better. Have you considered using the term restrictions?
2. In the introduction, you write about the aging population being specifically relevant to Italy. You provide statistics regarding the number of Italians who will be 65+ and 85+ years. How do these values compare to other European and/or Western countries?
3. In line 55, you write about family physicians advising patients to improve physical activity. There are other healthcare professionals who might also suggest to patients that they should enhance physical activity. E.g., nurses, nurse practitioners, physician assistants.
4. What was the research hypothesis?
5. Eligibility criteria are not listed in methods. These should be included.
6. There is no mention of a power analysis OR how the authors arrived at their sample size. This information is important to include.
7. There is no mention of IRB approval, protection of human subjects or informed consent being obtained. This information is important to include.
8. What type of sampling was used?
9. You write that the dancers did not dance for a full two years prior to the study -- and this was related to the COVID-19 pandemic. The WHO declared the pandemic in March 2020 -- thus, it does not add up that the dancers did not dance for two years because of the pandemic when the pandemic has not been ongoing, yet, for two years. Please clarify.
10. How was fidelity established? 
11. Line 152 -- you write that a t-paired test was used ... please confirm if this is meant to be t-paired test or paired t-test.
12. Were the assumptions of a paired t-test assessed? what were the results?
13. It appears that three of the participants met criteria for "improbable depression" at baseline. What is the rationale for including n=3 without depression?
14. Table 4 -- the results of the paired t-test are confusing. I entered the pre- and post-GDS scores (from table 2) in a statistical analysis program, and performed a paired t-test. The results are strikingly different. Indeed, the mean pre-GDS score is 8.41 (+/- 2.69) -- compared to what you reported as 8411 (+/- 26939). You might consider consulting with an experienced statistician.
15. The purpose of Table 5 is not clear. How do these results relate to the study aim or hypothesis?
16. Discussion -- you write about the dancers having negative feelings, not being satisfied with their lives, losing interesting and being bored related to the pandemic. However, I do not see these data reported in the results section. How do you know that they had negative feelings, etc.? If these data were collected, the data collection approach should be outlined, as well as the results. 
17. Similarly, how did you know that the dancers had increased energy? See line 195.
18. Line 185 -- did you collect data specific to attitudes? If so, this should be outlined in the data collection plan and in results. If not, you should not write about attitudes.
19. Line 193 -- same as my concerns outlined above -- it does not appear that you collected data with respect to satisfaction, life improvement, interest in activities, happiness and boredom.
20. Line 205 -- was stress measured?
21. The discussion section, in general, is lacking a compare and contrast to other studies. How does the current study compare to other studies of dance for depression in geriatric or other populations? What is the same or different about studies on dance for depression?
22. If this was a human subjects study, rather than referring to the individuals enrolled in the study as "dancers," they should be referred to as "participants."
23. The sample should be described in more detail...race/ethnicity, number of years dancing, baseline mental health diagnoses, medications for depression, substance use history, etc.
24. In the conclusion, you write that the study has important implications ... what are the important implications? Keep in mind that this was a small sample size (n=17) from a single arm study. The implications are limited based on the rigor of the study. 

Author Response

Dear Reviewer 1, you can find my answer in attachment. Sincerely. 

Author Response File: Author Response.pdf

Reviewer 2 Report

The acceptance of manuscript would depend on making minor revisions.

Comments for author File: Comments.pdf

Author Response

Dear Reviewer 2, you can find my answer in attachment. Sincerely.

Author Response File: Author Response.pdf