Review of: undefinedSwiss Ball Exercises for Constipation: Mechanistic Hypothesis, Evidence Quality Assessment, and Clinical Translation Frameworkundefined

Abstract

This manuscript presents a novel and clinically relevant hypothesis-generating narrative review on the potential role of Swiss ball exercises in constipation management.The manuscript is generally well organized and provides a plaus A major strength is the author's acknowledgment that no direct randomized controlled trials currently exist in adults with constipation and the clear positioning of the review as hypothesis-generating rather than con rmatory.However, several methodological and interpretative concerns should be addressed.In particular, the manuscript occasionally overextends indirect mechanistic evidence into clinical implications, and the methodological structure resembles a systemati Overall, the manuscript has potential, but some revisions are needed to improve methodological clarity, reduce overinterpretation, and better align the conclusions with the current level of evidence.Comments 1.Although the use of structured search strategies and quality assessment tools can strengthen narrative reviews, the current manuscript incorporates several methodological features commonly associated with systematic reviews, including prede ned eligibility criteria and formal quality appraisal.Clarifying the methodological positioning of the review would improve transparency and help readers distinguish this narrative synthesis from a formal systematic review or meta-analysis.