Furthermore, Routman et al26 showed that those with AF/SSFs treated with sling immobilization alone saw a 34.8-point increase in ASES and a 21.2° increase in active forward flexion, whereas our study demonstrated a 43.6-point increase in ASES and 46° increase in active forward flexion, possibly indicating a synergistic effect of intranasal calcitonin in conjunction to sling immobilization. Here, CALCA is linked to atrial fibrillation.