Comparison of the Efficacy of Different Traditional Chinese Exercises in the Treatment of Chronic Non-Specific Low Back Pain: A Bayesian Network Meta-Analysis Letter

Treatment of Chronic Non-Specific Low Back Pain: A Bayesian Network Meta-Analysis" by Min Huang et al. 1 This study represents a welcome contribution to the evidence base for Traditional Chinese Exercises (TCEs) in Chronic Non-Specific Low Back Pain (CNSLBP) rehabilitation, as it synthesizes multiple randomized controlled trials using rigorous statistical methods and provides the first high-level evidence synthesis for the comparative hierarchy of six specific TCEs, an analysis that is much needed for a class of clinical interventions with no head-to-head comparative data available.The study addresses a clinically relevant topic and adopts a Bayesian network meta-analysis design appropriate for multiple intervention comparisons, which is of significant potential value for guiding clinical rehabilitation practice.While the study's focus and methodological framework are highly meritorious, we wish to raise several concerns that may materially affect the certainty and applicability of the findings.First, the manuscript exhibits critical logical and methodological flaws in its statistical outcome ranking.These issues remain uncorrected in the supplementary materials and substantially compromise the study's rigor and interpretability.A basic counting error is present in the SUCRA rankings for VAS in Table 2: the rank for Baduanjin alone is incorrectly reported as 20, even though only 12 interventions are included.Second, the Discussion section contains a critical factual typo in the key statement outlining the study's academic contribution, where the authors incorrectly reference transcranial electrical stimulation therapies rather than traditional Chinese exercise therapies.This error renders the study's core claim unintelligible and entirely disconnected from its central research focus.Transcranial electrical stimulation is a neurostimulation technique that has no relevance to the TCEs evaluated in this manuscript, and this mistake directly distorts the authors' intended assertion regarding the role of TCEs in evidence-based non-pharmacological rehabilitation for CNSLBP.This is not a minor editorial error but a serious oversight that hinders readers' understanding of the study's key contributions and reflects insufficient proofreading and content verification on the part of the research team.Third, a critical, unaddressed issue related to exercise intensity significantly undermines the validity, interpretability, and clinical utility of all key findings, with the manuscript and supplementary materials lacking details of any reporting of this core component of exercise therapy defined by the FITT-VP principle (Frequency, Intensity, Time, Type, Volume, and Progression). 2,3While the authors briefly acknowledge intensity's potential impact in the Discussion section, they fail to incorporate it into any heterogeneity analyses or meta-regression models, instead including only intervention duration as a covariate and drawing unsubstantiated conclusions about duration-dependent efficacy.This makes the aforementioned oversight particularly problematic because, for CNSLBP, existing studies confirm that exercise intensity exerts a critical