Fig. 1.

STROBE flow diagram of participant enrollment, allocation, and follow-up. The study assessed 52 patients for eligibility, excluded 7 based on predefined criteria, and enrolled 45 participants. Following allocation by patient preference and 5 pre-baseline withdrawals, 40 participants (10 per group) initiated baseline measurements. All participants completed the 6-month follow-up (100% post-baseline retention) and were included in the per-protocol analysis. A total of 2,751 attachment sites were measured