Is Standardization the Future of Traditional Chinese Tuina (Massage) Therapy? A Reflection on “Bibliometric Analysis of Research Trends on Tuina Manipulation for Neck Pain Treatment Over the Past 10 Years” [Response to Letter]

Dear editor

We are glad for the attention received from peers after the publication of this article. We are appreciative of the opportunity given to us by the journal to respond to these comments. We will respond in the following points:

1. The letter states that, instead of using keywords such as “massage” or “manipulation”, we should use “tuina” or “Chinese manipulation”, which would lead to the retrieval of more modern physiotherapy literature and avoid bias. Our team did consider this question before searching, but we thought that some “tuina” literature would use the word “manipulation” in the title.¹ Therefore, in order to fully grasp the original intention of the field of tuina, we did not use only keywords such as “Chinese manipulation”.
2. It is true that the CNKI database was not used in the search conducted for this article. However, this is because it has less ability to influence and capture international trends, and the Web of Science Core Collection database is also good. Some articles also used only the WOS database for bibliometric analysis.² However, we also mention the lack of use of the CNKI database at various points in the article, including in the limitations section.
3. As mentioned in the letter, we cannot agree with the use of tuina as a surface intervention method instead of acupuncture. Several high-level studies^3,4 have mentioned that “ban fa” (high-speed and low-amplitude manipulations) is a type of tuina; however, the effects of these types of manipulation are completely different from those of acupuncture. And because acupuncture and tuina do not work at the same depth, each has its own strengths and is not a complete substitute for the other. Standardization is indeed a current trend in the field of tuina, but it cannot represent the whole. Evidence-based clinical practice is also an important method to promote the development of the tuina discipline.