Dear editor

We want to express our sincere gratitude for your allowing us to respond to the letter from Hao et al concerning our study.¹ We greatly cherish their recognition of our work, particularly the high praise of TCRE’s contributions to managing pain among older adults and in the context of long-term COVID-19.² However, regarding the research limitations of TCRE in young populations raised by Hao, we are willing to provide clarification and share our perspectives here. Indeed, our original intention was not merely to focus on these diseases but to acknowledge that current research primarily centers on them due to their close association with aging. Indeed, our article emphasizes the application and effects of TCRE in the elderly population, given the concentrated distribution of existing research data and the prevalent demand in clinical practice. This emphasis also resonates with the observation that most recent research since 2024 has continued to concentrate on elderly individuals,³ bone and joint degenerative diseases,⁴ and cardiovascular diseases,⁵ which are closely linked to aging.

We admit that high-quality research on TCRE in young populations is relatively limited, representing a notable gap in this field. One possible reason for this limitation could be young people’s relatively low interest and attention to traditional Chinese exercises, possibly due to their preference for modern activities. Despite the introduction of traditional exercise courses in numerous higher education institutions, young people often prefer to engage in contemporary sports. In China, for instance, yoga seems more popular among young individuals,⁶ highlighting a potential avenue for integrating traditional methods with modern practices. However, this does not imply that we have overlooked the needs of the young population or the potential value of TCRE in this group. On the contrary, we have been closely monitoring and encouraging the development of relevant research, anticipating a more comprehensive presentation of TCRE’s applicability across different age groups in the future.

Meanwhile, although research on TCRE in young populations is still insufficient, this does not mean its effects in this group are insignificant or unworthy of exploration. Conversely, we firmly believe that as a traditional and effective rehabilitation method, TCRE’s efficacy and potential deserve thorough investigation and validation across various populations. Therefore, we strongly agree with Hao et al’s suggestion to strengthen research on TCRE in young populations. We plan to pay closer attention to this area in future studies and strive to promote the development of related research. At the same time, we look forward to collaborating with Hao et al and more scholars to jointly explore the application value of TCRE in a broader demographic, contributing further to global health endeavors.