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Artacho-Cordón F, Salinas-Asensio MDM, Galiano-Castillo N, Ocón-Hernández O, Peinado FM, Mundo-López A, Lozano-Lozano M, Álvarez-Salvago F, Arroyo-Morales M, Fernández-Lao C, Cantarero-Villanueva I. Effect of a Multimodal Supervised Therapeutic Exercise Program on Quality of Life, Pain, and Lumbopelvic Impairments in Women With Endometriosis Unresponsive to Conventional Therapy: A Randomized Controlled Trial. Arch Phys Med Rehabil 2023; 104:1785-1795. [PMID: 37467936 DOI: 10.1016/j.apmr.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of "Physio-EndEA", a multimodal nine-week supervised exercise intervention, on quality of life, pain, and lumbopelvic impairments in women with endometriosis unresponsive to conventional therapy. DESIGN Parallel-group randomized controlled trial. Outcomes were measured at baseline, post-intervention, and at 1 year. SETTING Two Public University Hospitals. PARTICIPANTS This trial included 31 women with endometriosis (N=31) randomly allocated to "Physio-EndEA" group (n=16) or control group (n=15). Four participants dropped out of the study for causes unrelated to the intervention. INTERVENTIONS The "Physio-EndEA" program consisted of a 1-week lumbopelvic stabilization learning phase followed by an 8-week phase of stretching, aerobic, and resistance exercises focused on the lumbopelvic area. It was sequentially instructed and supervised by a trained physiotherapist (with volume and intensity progression) and adapted daily to the potential of each participant. Control group received the usual treatment stipulated by their gynecologist. MAIN OUTCOME MEASURES The primary outcome was quality of life. Secondary outcomes were pain intensity, pressure pain thresholds, pain-related catastrophic thoughts, abdominal and back strength, lumbopelvic stability, and muscle architecture. RESULTS Adherence rate was 90.6% and mean (±standard deviation) satisfaction was 9.44±0.73 out of 10. No remarkable health problems were reported during the trial. In comparison with controls, the quality of life was improved post-intervention and at 1 year in the Physio-EndEA group with large effect sizes (d>0.80). This group also evidenced: a reduced intensity of dyspareunia, catastrophic thoughts; an increase in pelvic, lumbar, and distal pressure pain thresholds; increases in abdominal and back strength and lumbopelvic stability; and increased thickness of transversus abdominis (right side) and width of lumbar multifidus (left side). CONCLUSION A 9-week program of multimodal supervised therapeutic exercise is a feasible and effective intervention to improve QoL in women with endometriosis. This program also offers benefits in terms of pain/sensitization and lumbopelvic impairments.
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Affiliation(s)
- Francisco Artacho-Cordón
- Department of Radiology and Physical Medicine, University of Granada, Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | | | - Noelia Galiano-Castillo
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Olga Ocón-Hernández
- Gynaecology and Obstetrics Unit, "San Cecilio" University Hospital, Granada, Spain
| | | | | | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | | | - Manuel Arroyo-Morales
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Carolina Fernández-Lao
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Irene Cantarero-Villanueva
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
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Artacho-Cordón F, Lorenzo Hernando E, Pereira Sánchez A, Quintas-Marquès L. Conceptos actuales en dolor y endometriosis: diagnóstico y manejo del dolor pélvico crónico. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2023. [DOI: 10.1016/j.gine.2023.100843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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del Mar Salinas-Asensio M, Ocón-Hernández O, Mundo-López A, Fernández-Lao C, Peinado FM, Padilla-Vinuesa C, Álvarez-Salvago F, Postigo-Martín P, Lozano-Lozano M, Lara-Ramos A, Arroyo-Morales M, Cantarero-Villanueva I, Artacho-Cordón F. 'Physio-EndEA' Study: A Randomized, Parallel-Group Controlled Trial to Evaluate the Effect of a Supervised and Adapted Therapeutic Exercise Program to Improve Quality of Life in Symptomatic Women Diagnosed with Endometriosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031738. [PMID: 35162761 PMCID: PMC8834829 DOI: 10.3390/ijerph19031738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/18/2022] [Accepted: 01/30/2022] [Indexed: 11/16/2022]
Abstract
Aim: The ‘Physio-EndEA’ study aims to explore the potential benefits of a therapeutic exercise program (focused on lumbopelvic stabilization and tolerance to exertion) on the health-related quality of life (HRQoL) of symptomatic endometriosis women. Design: The present study will use a parallel-group randomized controlled trial design. Methods: A total of 22 symptomatic endometriosis women will be randomized 1:1 to the Physio-EndEA or usual care groups. The ‘Physio-EndEA’ program will consist of a one-week lumbopelvic stabilization learning phase followed by an eight-week phase of stretching, aerobic and resistance exercises focused on the lumbopelvic area that will be sequentially instructed and supervised by a trained physiotherapist (with volume and intensity progression) and adapted daily to the potential of each participant. The primary outcome measure is HRQoL. The secondary outcome measures included clinician-reported outcomes (pressure pain thresholds, muscle thickness and strength, flexibility, body balance and cardiorespiratory fitness) and patient-reported outcomes (pain intensity, physical fitness, chronic fatigue, sexual function, gastrointestinal function and sleep quality). Discussion: Findings of this study will help to identify cost-effective non-pharmacological options (such as this exercise-based intervention) that may contribute to the improvement of HRQoL in symptomatic endometriosis women.
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Affiliation(s)
- María del Mar Salinas-Asensio
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
- Correspondence: (M.d.M.S.-A.); (F.A.-C.)
| | - Olga Ocón-Hernández
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- Gynaecology and Obstetrics Unit, ‘San Cecilio’ University Hospital, E-18016 Granada, Spain
| | | | - Carolina Fernández-Lao
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Francisco M. Peinado
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
| | - Carmen Padilla-Vinuesa
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- Gynaecology and Obstetrics Unit, ‘San Cecilio’ University Hospital, E-18016 Granada, Spain
| | | | - Paula Postigo-Martín
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Ana Lara-Ramos
- Gynaecology and Obstetrics Unit, ‘Virgen de las Nieves’ University Hospital, E-18012 Granada, Spain;
| | - Manuel Arroyo-Morales
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Francisco Artacho-Cordón
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
- Department of Radiology and Physical Medicine, University of Granada, E-18016 Granada, Spain
- CIBER Epidemiology and Public Health (CIBERESP), E-28029 Madrid, Spain
- Correspondence: (M.d.M.S.-A.); (F.A.-C.)
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Sima RM, Pleş L, Socea B, Sklavounos P, Negoi I, Stănescu AD, Iordache II, Hamoud BH, Radosa MP, Juhasz-Boess I, Solomayer EF, Dimitriu MCT, Cîrstoveanu C, Şerban D, Radosa JC. Evaluation of the SF-36 questionnaire for assessment of the quality of life of endometriosis patients undergoing treatment: A systematic review and meta-analysis. Exp Ther Med 2021; 22:1283. [PMID: 34630638 PMCID: PMC8461506 DOI: 10.3892/etm.2021.10718] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/16/2021] [Indexed: 12/23/2022] Open
Abstract
Endometriosis has a negative influence on the physical, psychological, and social aspects of a patient's life; therefore, it affects the health-related quality of life (HRQoL). The current review aimed to investigate the efficiency of a 36-item generic questionnaire survey (SF-36) for patients with endometriosis who were undergoing medical or surgical treatment. A search strategy including the key words ‘endometriosis’, ‘quality of life’ (QOL), and ‘questionnaire SF-36’ was applied using the PubMed/MEDLINE, EMBASE, and Cochrane databases in order to include articles that evaluated the QOL among women with endometriosis using the SF-36. Only articles that included interviews of patients both before and after surgical or medical endometriosis treatment or those articles that compared study groups were considered. The qualitative analysis was based on 37 articles, whereas the quantitative analysis utilized 14 articles. The research participants included 11,101 women, among whom 6,888 patients were diagnosed with endometriosis. The analysis recorded 17 studies dealing with all types of endometriosis, 9 studies dealing with deep infiltrative endometriosis (DIE), and 9 studies dealing with bowel endometriosis or DIE with bowel involvement. QOL was evaluated using only SF-36 in 12 studies that collectively included 1,912 women and using SF-36 in association with other questionnaires in 25 studies that collectively included 8,022 women. For patients with endometriosis, physical functioning [odds ratio (OR), 78.87; 95% confidence interval (CI), 68.97-88.77; I2=98.77%; P≤0.001] was the most affected life parameter. This parameter showed the highest improvement after surgical intervention (OR, 63.39; 95% CI, 48.71-78.07; I2=97.65%; P≤0.001) or hormonal treatment (OR, 38.65; 95% CI, 14.39-62.91; I2=38.65%; P≤0.001). The 36-item survey generic questionnaire seems to be an efficient tool for assessment of the QOL of life of women with endometriosis who are undergoing surgical or medical treatment. It can be applied before and after the procedure, and it can also be used for comparing study groups.
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Affiliation(s)
- Romina-Marina Sima
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Obstetrics and Gynecology, 'Sf. Ioan' Hospital, Bucur Maternity, 040294 Bucharest, Romania
| | - Liana Pleş
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Obstetrics and Gynecology, 'Sf. Ioan' Hospital, Bucur Maternity, 040294 Bucharest, Romania
| | - Bogdan Socea
- Department of Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Surgery, 'Sf. Pantelimon' Emergency Hospital, 021659 Bucharest, Romania
| | - Panagiotis Sklavounos
- Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, D-66421 Homburg, Germany
| | - Ionuţ Negoi
- Department of Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Surgery, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
| | - Anca-Daniela Stănescu
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Obstetrics and Gynecology, 'Sf. Ioan' Hospital, Bucur Maternity, 040294 Bucharest, Romania
| | - Ioan-Iulian Iordache
- Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, D-66421 Homburg, Germany
| | - Bashar Haj Hamoud
- Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, D-66421 Homburg, Germany
| | - Marc Phillip Radosa
- Department of Gynecology, University Hospital Leipzig, D-04103 Leipzig, Germany
| | - Ingolf Juhasz-Boess
- Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, D-66421 Homburg, Germany
| | - Erich Franz Solomayer
- Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, D-66421 Homburg, Germany
| | - Mihai C T Dimitriu
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Obstetrics and Gynecology, 'Sf. Pantelimon' Emergency Hospital, 021659 Bucharest, Romania
| | - Cătălin Cîrstoveanu
- Department of Pediatrics, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Pediatrics Department, 'Maria Sklodowska Curie' Emergency Children Clinical Hospital, 041451 Bucharest, Romania
| | - Dragoş Şerban
- Department of Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Surgery, University Emergency Hospital, 050098 Bucharest, Romania
| | - Julia Caroline Radosa
- Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, D-66421 Homburg, Germany
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Zhang ZY, Wang J, Fan YL, Wang BY, Zhang WT. Effectiveness of neuromuscular electrical stimulation for endometriosis-related pain: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20483. [PMID: 32569169 PMCID: PMC7310956 DOI: 10.1097/md.0000000000020483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study will assess the effectiveness and safety of neuromuscular electrical stimulation (NMES) for endometriosis-related pain (ERP). METHODS Seven electronic databases of Cochrane Library, PUBMED, EMBASE, WANGFANG, VIP, CBM, and CNKI will be searched. We will search all electronic databases related the randomized controlled trials (RCTs) on the effectiveness and safety of NMES for ERP up to the March 31, 2020 without restrictions of language. RevMan 5.3 software will be used for risk of bias assessment, related data analysis and meta-analysis. RESULTS This systematic review and meta-analysis will summarize current high-quality RCTs on the effectiveness and safety of NMES for ERP. Results of this study will provide the basis for both clinician and further research. CONCLUSION This study will investigate whether NMES is effective and safety for the treatment of ERP. SYSTEMATIC REVIEW REGISTRATION INPLASY202040191.
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Affiliation(s)
| | | | | | | | - Wei-Ting Zhang
- Department of Internal Medicine, Affiliated Hongqi Hospital of Mudanjiang Medical University, Mudanjiang, China
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Yu T, Tang HY, Wang TS, Wei W. Effectiveness of electrical stimulation for postoperative pain in patients with osteosarcoma: A systematic review protocol of clinical controlled trial. Medicine (Baltimore) 2019; 98:e16783. [PMID: 31393405 PMCID: PMC6709289 DOI: 10.1097/md.0000000000016783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study aims to investigate the effectiveness and safety of electrical stimulation (ES) for postoperative pain (PPP) in patients with osteosarcoma systematically. METHODS We will systematically search the following electronic databases from inception to the May 1, 2019: MEDILINE, Cochrane Library, EMBASE, Web of Science, Springer, and CNKI without language restrictions. All literatures of randomized controlled trials (RCTs) and case-controlled studies (CCSs) of ES for PPP in patients with osteosarcoma will be included. RevMan 5.3 software (Cochrane Community; London, UK) and STATA 15.0 software (StataCorp; College Station) will be used for statistical analysis. Cochrane risk of bias will be used for methodological quality assessment for RCTs and Newcastle-Ottawa Scale will be utilized for CCSs. RESULTS This study will assess the clinical effectiveness and safety of ES for PPP in patients with osteosarcoma through assessing primary outcome of pain intensity and secondary outcomes of frequency of rescue analgesic use, cumulative morphine consumption, quality of recovery, as well as adverse events. CONCLUSION This study will provide latest evidence on effectiveness and safety of ES for PPP in patients with osteosarcoma, and may also provide guidance for both clinician and further studies. DISSEMINATION AND ETHICS This study does not require ethical approval, because it will not analyze the individual patient data. Its results are expected to be published in peer-reviewed journals. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019135790.
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Ji QH, Qiao XF, Wang SF, Zhao P, Liu SC, Xue Y, Qiao JM, Li YB. Effectiveness of neuromuscular electrical stimulation and ibuprofen for pain caused by necrosis of the femoral head: A retrospective study. Medicine (Baltimore) 2019; 98:e14812. [PMID: 30882660 PMCID: PMC6426472 DOI: 10.1097/md.0000000000014812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This retrospective study analyzed the effectiveness of neuromuscular electrical stimulation (NMES) for pain relief caused by necrosis of femoral head (NFH).Totally, 80 cases of patients with NFH were analyzed and then were assigned to a treatment group or a control group in this study. Of these, 40 cases in the treatment group received ibuprofen and NMES therapy. The other 40 cases in the control group received ibuprofen alone. Cases in both groups were treated for a total of 6 weeks. The primary outcome of pain intensity was measured by a visual analog scale (VAS). The secondary outcome was assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). In addition, adverse events (AEs) were also recorded in each case. All outcomes were evaluated before and after the treatment.After treatment, patients in the treatment group showed more effectiveness in pain relief, as measured by VAS (P < .01) and WOMAC sub-pain scale (P < .01), except stiffness, as evaluated by WOMAC sub-stiffness scale (P = .07), and function, as assessed by WOMAC sub-function scale (P = .09), than patients in the control group. Additionally, no significant differences in AEs were detected between 2 groups.This study found that NMES may be helpful for pain relief in patients with NFH.
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Affiliation(s)
- Qing-Hui Ji
- First Ward of Orthopedics Department, First Affiliated Hospital of Jiamusi University
| | - Xiao-Feng Qiao
- First Ward of Orthopedics Department, First Affiliated Hospital of Jiamusi University
| | - Shou-Feng Wang
- First Ward of Orthopedics Department, First Affiliated Hospital of Jiamusi University
| | - Peng Zhao
- Department of Orthopedics, Jiamusi Central Hospital
| | - Shi-Chen Liu
- First Ward of Orthopedics Department, First Affiliated Hospital of Jiamusi University
| | - Yu Xue
- Department of Surgery, Second Affiliated Hospital of Jiamusi University, Jiamusi
| | - Jian-Min Qiao
- First Ward of Orthopedics Department, First Affiliated Hospital of Jiamusi University
| | - Yan-Bao Li
- Department of Orthopedics, Handan Central Hospital, Handan, China
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