We thank the authors for their interest in our study comparing the effects of a home-based pulmonary rehabilitation program with and without telecoaching on health-related outcomes in COVID-19 survivors. (1) We are grateful for the valuable comments on our manuscript and are happy to respond to their comments as follows.
 
Firstly, since our assumptions meet the general linear models, we used two-way ANOVA for repeated measures from general linear models in our study. While building the model, we set it up in factorial design. Therefore, we tried to reduce the heterogeneity for the variances as much as possible.(2)
 
Then, we would like to underline that the values in Table 3(1) in our study are presented as the standard error of mean, not standard deviation. This misunderstanding can cause the effect size values calculated by the authors to be confusing for the readers. Considering that the standard error of mean is calculated with the formula (standard deviation/Ѵn), they have been specified as too large. Therefore, we calculated the Cohen’s effect size values of our main results with the formula d = (X1 − X2)/standard deviation for both groups (ds = dstudy; dc = dcontrol).(3) We interpreted our results with the effect size values to summarize their clinical significance.
 
After the rehabilitation program, the effect size of the change in FVC was moderate in the study group but higher than in the control group (ds = 0.56; dc = 0.48). As we mentioned in our study, the most important clinical gain in the study group was in the daily life dyspnea score (ds = 1.30; dc = 0.43). Large effect size was obtained in the six-minute walk distance in both groups, being relatively higher in the study group (ds = 0.90; dc = 0.82). Exertional dyspnea and fatigue scores improved only in the study group, and their effect sizes were found to be d = 0.70 and d = 0.64, respectively. While the effect size calculated for our results regarding the gains in muscle strength was d > 0.5 for deltoid and quadriceps femoris muscles in the study group, the effect size obtained for biceps muscle strength in the control group was higher than in the study group (d > 0.5).
 
The effect size of the change in the Saint George’s Respiratory Questionnaire activity score was higher in the study group (ds = 0.62; dc = 0.56), and the effect size of the change in the impact (ds = 0.73; dc = 0.88), and of the total score (ds = 0.84; dc = 0.90) was higher in the control group. The highest effect size in the Medical Outcomes Study 36-item Short-Form Health Survey in the study group was in the social functioning domain (ds = 1.28; dc = 0.46). Although there was a small decrease in anxiety and depression scores in both groups, it was concluded that the effect size for these values was d < 0.50.
 
As a result, as emphasized in our study, although there were different gains on different variables in both groups, improvements in daily life dyspnea and social functioning were higher and had a larger effect size in the study group than in the control group.
 
REFERENCES
 
1.            Şahın H, Naz İ, Karadeniz G, Süneçlı O, Polat G, Ediboğlu O. Effects of a home-based pulmonary rehabilitation program with and without telecoaching on health-related outcomes in COVID-19 survivors: a randomized controlled clinical study. J Bras Pneumol. 2023;49(1):e20220107. https://doi.org/10.36416/1806-3756/e20220107
2.            Park E, Cho M, Ki CS. Correct use of repeated measures analysis of variance. Korean J Lab Med. 2009;29(1):1-9. https://doi.org/10.3343/kjlm.2009.29.1.1
3.            Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale NJ: Lawrence Erlbaum Associated; 1988.