PLOS One Flags Peer Review Concerns in Pelvic Floor Muscle Study
PLOS One has issued an Expression of Concern for a 2024 paper on electromyographic activity of pelvic floor muscles during the use of an innovative vaginal educator. The journal said the article was identified as one of a series of submissions for which there are concerns about the integrity and reliability of the peer review process.
The notice does not retract the paper, and it does not claim misconduct by the authors. It does, however, tell readers to treat the article with caution while those review-process concerns remain unresolved.
What the Journal Did — and Did Not — Conclude
The editorial notice is narrow in scope. PLOS said it did not evaluate the paper’s scientific validity or its underlying data as part of this follow-up. The concern centers on how the manuscript moved through peer review, not on a specific proven flaw in the study itself.
PLOS also said it has no evidence of author involvement in the peer review concerns. The named editor on the article was a PLOS Staff Editor who was not involved in the concerns and was unaware of the peer review issues before publication.
That distinction matters for clinicians, researchers, and readers who rely on the medical literature. An Expression of Concern signals uncertainty about the publication pathway, not a formal finding that every result in the paper is wrong.
The original article, authored by Duarte Nds, Azevedo YSD, Furtado ECS, Araújo LJFD, Bendelack RM, Rodrigues CNC, and colleagues, examined pelvic floor muscle electromyographic activity in different positions during the use of a vaginal educator. The paper appeared in PLoS One in 2024.
Why Peer Review Integrity Matters in Clinical Research
Studies involving pelvic floor function often inform rehabilitation strategies, physical therapy approaches, and patient counseling around intimate health concerns. When the review process for such work is questioned, the downstream effect can reach far beyond one paper. Clinicians may continue citing the findings, educators may fold them into teaching materials, and future investigators may build on a foundation that has not been fully secured.
Electromyography is commonly used to assess muscle activation, fatigue patterns, and neuromuscular coordination. In pelvic floor research, those measurements can shape how investigators think about posture, device use, exercise technique, and functional engagement of targeted muscle groups. A publication attached to uncertain peer review does not automatically lose all value, but it does move into a category where caution is the correct reading posture.
The journal’s action reflects an increasingly familiar problem in biomedical publishing: a paper can remain online while editors examine whether the gatekeeping process operated as intended. For readers, that means the article stays visible, but its authority is no longer uncomplicated.
The Study Topic Still Sits in a Clinically Sensitive Area
The paper focused on pelvic floor muscle activity during the use of an innovative vaginal educator across different positions. Even without revisiting the study’s numerical findings, the topic itself sits at the intersection of rehabilitation medicine, women’s health, and exercise-based intervention research.
Pelvic floor dysfunction affects continence, sexual health, pelvic support, and quality of life. Because of that breadth, small shifts in how a study is designed, reviewed, and interpreted can ripple into practice. Position-dependent changes in muscle activation may be biologically plausible, but plausibility is not a substitute for a trustworthy review trail.
A single sentence in a journal notice can carry substantial weight for the medical readership: this paper should be interpreted with consideration of the peer review issue. That is the practical instruction embedded in the editorial note.
What Readers Should Take From the Expression of Concern
For clinicians, the immediate task is not to discard every conclusion tied to the article, but to recognize that the publication record now includes a formal editorial warning. Citations, journal clubs, and literature reviews should reflect that status. If the study is discussed in academic or clinical settings, the Expression of Concern belongs in the same conversation as the article itself.
For researchers in pelvic floor rehabilitation, the notice also serves as a reminder that methodological scrutiny extends beyond sample size, endpoints, and statistics. The credibility of a paper depends on the full chain of editorial review that brings it into the literature. When that chain is questioned, confidence in the paper naturally changes.
The notice leaves several concrete questions unanswered. It does not state whether the peer review concerns affected this particular article directly or arose from broader submission patterns. It does not provide a technical critique of the data, the analysis, or the conclusions. And it does not offer a timeline for any further editorial action.
Until more information appears, the paper remains part of the literature under cautionary flag. Readers using it to guide pelvic floor research or clinical education should do so with the new editorial context in mind.