Reviewer’s report
Title:  Structured  physical  activity  interventions  as  a  complementary  therapy  for  patients  with  
inflammatory bowel disease – a scoping review and practical implications
Version: 2 Date: 11 May 2019
Reviewer: Arun Swaminath
Reviewer's report:
Review for BMC Gastroenterology  
Structured  physical  activity interventions  as  a  complementary therapy for  patients  with  IBD  -  A  
systematic review and practical implications. 
Ekert et al.  
 
A very timely review of the data behind physical activity and it's value to management of IBD patients,  
though the data from included papers was too disparate to combine.  The authors summarized a more  
qualitative analysis. 
 
Minor Comments 
Please comment on whether a research librarian was included in creating search terms / strategy.  
Line 102: UC not "CU" 
Line 161 - Month should be "months" 
Line 170 - chances should be "changes" 
"mind-body therapies" - needs a more detailed description. 
Line 212 "metric clinical" - unclear what this means 
2nd paragraph of discussion better fits into the background 
Line 255 - moderate misspelled. 
Major Comments: 
1. Study selection: "only articles written" - later state that two abstract and a letter to editor were  
included due to relevance....did these 3 references meet your study selection criteria?  If not,  
should the original search terms have been broadened to see if any other references could have  
been identified outside of serendipity? 
2. Many of the studies included both UC and CD patients, but only reference to disease activity  
indices were HBI (a Crohn's related measure) - was there something specific for UC patients? 
3.  Strength training section: "failed to decrease the disease activity HBI significantly" - would. be  
useful for the reader to actually see what the baseline values and the delta was - gives a stronger  
sense of what kind of patient from a disease severity perspective was included to begin with. 
4.   "our  analysis  indicated  positive  tendencies"  -  given  that  most  of  the  measure  remained  
unchanged per your own discussion and the fact that prior PA wasn't measured, this doesn't  
seem a supported statement. 
5.  The second "main goal" of the paper is listed as developing "PA recommendations, which are  
specific for IBD patients."  This is not included in the paper (though recommendations for how  
to improve the quality of future trials are, and possibly this is what was meant). 
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you recommend an additional  
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further  
assessment in your comments to the editors.
Not relevant to this manuscript
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If  
your reply is yes to any, please give details below.
I declare no competing interests
I agree to the open peer review policy of the journal. I understand that my name will be included on my  
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not  
be published.
I agree to the open peer review policy of the journal
Reviewer’s report
Title:  Structured  physical  activity  interventions  as  a  complementary  therapy  for  patients  with  
inflammatory bowel disease – a scoping review and practical implications
Version: 2 Date: 11 May 2019
Reviewer: Arun Swaminath
Reviewer's report:
Review for BMC Gastroenterology  
Structured  physical  activity interventions  as  a  complementary therapy for  patients  with  IBD  -  A  
systematic review and practical implications. 
Ekert et al.  
 
A very timely review of the data behind physical activity and it's value to management of IBD patients,  
though the data from included papers was too disparate to combine.  The authors summarized a more  
qualitative analysis. 
 
Minor Comments 
Please comment on whether a research librarian was included in creating search terms / strategy.  
Line 102: UC not "CU" 
Line 161 - Month should be "months" 
Line 170 - chances should be "changes" 
"mind-body therapies" - needs a more detailed description. 
Line 212 "metric clinical" - unclear what this means 
2nd paragraph of discussion better fits into the background 
Line 255 - moderate misspelled. 
Major Comments: 
1. Study selection: "only articles written" - later state that two abstract and a letter to editor were  
included due to relevance....did these 3 references meet your study selection criteria?  If not,  
should the original search terms have been broadened to see if any other references could have  
been identified outside of serendipity? 
2. Many of the studies included both UC and CD patients, but only reference to disease activity  
indices were HBI (a Crohn's related measure) - was there something specific for UC patients? 
3.  Strength training section: "failed to decrease the disease activity HBI significantly" - would. be  
useful for the reader to actually see what the baseline values and the delta was - gives a stronger  
sense of what kind of patient from a disease severity perspective was included to begin with. 
4.   "our  analysis  indicated  positive  tendencies"  -  given  that  most  of  the  measure  remained  
unchanged per your own discussion and the fact that prior PA wasn't measured, this doesn't  
seem a supported statement. 
5.  The second "main goal" of the paper is listed as developing "PA recommendations, which are  
specific for IBD patients."  This is not included in the paper (though recommendations for how  
to improve the quality of future trials are, and possibly this is what was meant). 
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you recommend an additional  
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further  
assessment in your comments to the editors.
Not relevant to this manuscript
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If  
your reply is yes to any, please give details below.
I declare no competing interests
I agree to the open peer review policy of the journal. I understand that my name will be included on my  
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not  
be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’s report
Title:  Structured  physical  activity  interventions  as  a  complementary  therapy  for  patients  with  
inflammatory bowel disease – a scoping review and practical implications
Version: 2 Date: 11 May 2019
Reviewer: Arun Swaminath
Reviewer's report:
Review for BMC Gastroenterology  
Structured  physical  activity interventions  as  a  complementary therapy for  patients  with  IBD  -  A  
systematic review and practical implications. 
Ekert et al.  
 
A very timely review of the data behind physical activity and it's value to management of IBD patients,  
though the data from included papers was too disparate to combine.  The authors summarized a more  
qualitative analysis. 
 
Minor Comments 
Please comment on whether a research librarian was included in creating search terms / strategy.  
Line 102: UC not "CU" 
Line 161 - Month should be "months" 
Line 170 - chances should be "changes" 
"mind-body therapies" - needs a more detailed description. 
Line 212 "metric clinical" - unclear what this means 
2nd paragraph of discussion better fits into the background 
Line 255 - moderate misspelled. 
Major Comments: 
1. Study selection: "only articles written" - later state that two abstract and a letter to editor were  
included due to relevance....did these 3 references meet your study selection criteria?  If not,  
should the original search terms have been broadened to see if any other references could have  
been identified outside of serendipity? 
2. Many of the studies included both UC and CD patients, but only reference to disease activity  
indices were HBI (a Crohn's related measure) - was there something specific for UC patients? 
3.  Strength training section: "failed to decrease the disease activity HBI significantly" - would. be  
useful for the reader to actually see what the baseline values and the delta was - gives a stronger  
sense of what kind of patient from a disease severity perspective was included to begin with. 
4.   "our  analysis  indicated  positive  tendencies"  -  given  that  most  of  the  measure  remained  
unchanged per your own discussion and the fact that prior PA wasn't measured, this doesn't  
seem a supported statement. 
5.  The second "main goal" of the paper is listed as developing "PA recommendations, which are  
specific for IBD patients."  This is not included in the paper (though recommendations for how  
to improve the quality of future trials are, and possibly this is what was meant). 
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you recommend an additional  
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further  
assessment in your comments to the editors.
Not relevant to this manuscript
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If  
your reply is yes to any, please give details below.
I declare no competing interests
I agree to the open peer review policy of the journal. I understand that my name will be included on my  
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not  
be published.
I agree to the open peer review policy of the journal
assistant