Statistical analysis
Descriptive statistics were used to determine the mean and standard deviation of variables, and Shapiro-Wilk test was used to examine the normality of the distribution. Within-group changes were examined using a dependent t-test, while between-group comparisons were made using a repeated-measures ANOVA, Bonferroni's post hoc test. All analyses were performed with SPSS software (version 26) at a P<0.05.