Body Cryotherapy Research Articles

The effects of cold water immersion and partial body cryotherapy on subsequent exercise performance and thermoregulatory responses in hot conditions

This study investigated the effects of cold water immersion (CWI) and partial body cryotherapy (PBC) applied within a 15-min post-exercise recovery period on thermoregulatory responses, subjective perceptions, and exercise performance under hot conditions (39 °C). Twelve male soccer players participated in team-sports-specific assessments, including Agility T-test (T-test), 20-m sprint test (20M-ST), and Yo-Yo Intermittent Endurance Test Level 1 (YY-T), during two exercise bouts (1st bout and 2nd bout) with a 15-min post-exercise recovery period. Within the recovery period, a 3-min of PBC at −110 °C or CWI at 15 °C or a seated rest (CON) was performed. Mean skin temperature (Tskin) decreased by 4.3 ± 1.08°C (p < 0.001) immediately after PBC, while CWI induced a reduction of 2.5 ± 0.21°C (p < 0.01). Furthermore, PBC and CWI consistently reduced Tskin for 15 and 33 min, respectively (p < 0.05). During the 2nd bout, core temperature (Tcore) was significantly lower in PBC compared to CON (p < 0.05). Heart rate (HR) was significantly lower in CWI compared to CON and PBC during the intervention period. Thermal sensation (TS) was significantly greater in PBC compared to CON and CWI (p < 0.05). Compared to the 1st bout, PBC alleviated the declines in T-test (p < 0.05) and 20M-ST (p < 0.05), while CWI alleviated the decreases in T-test (p < 0.05) and YY-T (p < 0.05), concurrently significantly enhancing 20M-ST (p < 0.05). 20M-ST and YY-T was greater from PBC (p < 0.05) and CWI (p < 0.05) compared with CON in 2nd bout. Additionally, the T-test in CWI was significantly greater than CON (p < 0.05). These results indicate that both PBC and CWI, performed between two exercise bouts, have the potential to improve thermoregulatory strain, reduce thermal perceptual load, and thereby attenuate the subsequent decline in exercise performance.

The Perspective of Whole Body Cryotherapy in Rheumatic Diseases: A Narrative Review

WBC could be an “add-on therapy” useful in the management of several Rheumatic diseases, even though numerous aspects need to be clarified, as shown in the research agenda proposed in this review. Hence, further studies are necessary to establish standardized protocols

Human body numerical simulation: An accurate model for a thigh subjected to a cold treatment

This article presents the development of a digital twin model of a thigh portion subjected to various thermal treatments. Two scenarios are investigated: cold water immersion (CWI) and whole body cryotherapy (WBC), for which the comparison of numerical results with experimental measurements validates the consistency of the developed model. The use of real geometry on a first subject demonstrates the high heterogeneity of the temperature field and the need for accurate geometry. A second subject with thicker adipose tissue highlights the impact of the subject’s actual morphology on the validity of the treatment and the necessity to work with real geometry in order to optimize cold modalities and develop personalized treatments.

Experimental evaluation of partial body cryotherapy unit with gas supply regulation

The partial body cryotherapy is a medical treatment that uses a physical factor to stimulate the main part of body surface. Today physicians do not have the technical ability to improve this method towards predictive and personalized medicine. Different patients have different dimensions and other features (physique, sex, age, adaptation level, etc.). However, physicians are able to set only the exposure duration. In this case, the skin cooling uncertainty and non-uniformity reduces the safety and effectiveness of cryoexposure. The key to upgrade cryotherapy is increasing the number of parameters to achieve a less skin temperature difference at the end of exposure and to plan a given skin cooling for different patients by reducing the intensity of cooling. This article is aimed to experimentally evaluate the novel partial body cryotherapy unit that has the ability to regulate: the gas temperature in the cryocabin; the inlet jet direction and the exposure duration. Based on the proposed model of a human as an object of cooling, using the developed unit, the adopted cryoexposure protocol and the presented approach to the analysis of infrared images, experiments were conducted. Data were obtained on the participant's interview and skin temperature. It is shown that the approach used is safety treatment and make it possible to obtain an improved and controlled skin temperature distribution at the end of cryoexposure. It might be relevant for improving cryotherapy protocols and for equipment development.

Effect of whole-body cryotherapy treatments on blood morphology and blood rheology: red blood cell deformability, red blood cell aggregation in healthy subjects.

assessment of the effect of a series of 20 whole-body cryotherapy sessions on the morphological and rheological indicators of blood in healthy people. The experimental group consisted of 15 women and 15 men who underwent a series of whole-body cryotherapy treatments. The control group consisted of 15 women and 15 men - without intervention. For the analysis of blood biochemical parameters, venous blood was collected twice: Study 1: on the day of the commencement of whole body cryotherapy / from the control group; and Study 2: after a series of 20 cryotherapy sessions / from the control group (4 weeks). After whole-body cryotherapy a statistically significant decrease in RBC, HGB, HCT, MCV, EI 0.30 and an increase in MCHC and EI 2.19-60.30 were observed in women, as well as a decrease in MCV, MCH, AI and an increase in PLT, EI 0.30-60.30, AMP, T1/2 in men. The use of whole-body cryotherapy causes changes in blood counts in various directions and has a positive effect on the rheological properties of blood in women and men - it increases the elongation index and reduces the aggregation index.

Whole Body Cryotherapy in Sport and Physical Activity: A Narrative Review

Cold therapy application is commonly used to relieve pain symptoms, to reduce inflammation in chronic diseases and damage in injuries at the musculoskeletal level. Two types of technologies, Partial Body Cryotherapy (PBC) or Whole Body Cryotherapy (WBC), are available in the market. This narrative review reports data from trials exploring WBC in Sport and in physical activity with the aim to show limitations and effectiveness in healthy subjects performing sport activity. The systematic search was conducted on the past ten years. The search keywords were "Whole Body Cryotherapy" OR "Cryogenic chamber therapy" OR "Cryostimulation" AND "Sport" OR "Exercise" OR "Athlete" OR "Physical Activity." The sample size, subject’s age and gender, year of publication, duration and temperature of exposition, physical activity and outcomes were extracted. 15 articles met the inclusion criteria. Data on 265 subjects aged between 20 to 56 years were reported. The WBC protocols covered temperatures from -20 to -120 degrees Celsius. Exposure times ranged from 1 minute to 3 minutes. The cryostimulation sessions were coupled to normal daily recreational activities or, in the case of athletes, competitive activities during the competition season. WBC is a safe procedure and no major adverse events neither alteration of vital parameters were reported. The benefits have been found especially in post-exercise DOMS. Since many aspects need to be clarified a research agenda has been produced to answer crucial questions. In conclusion WBC seems to be a useful tool in Sport Medicine. However, further studies are necessary to establish standardized protocols.

Partial body cryotherapy exposure drives acute redistribution of circulating lymphocytes: preliminary findings

Partial body cryotherapy (PBC) is proposed to alleviate symptoms of exercise-induced muscle damage (EIMD) by reducing associated inflammation. No studies have assessed acute PBC exposure on peripheral blood mononuclear cell mobilisation or compared these with cold water immersion (CWI), which may inform how PBC impacts inflammatory processes. This trial examined the impact of a single PBC exposure on circulating peripheral blood mononuclear cells compared to CWI or a control. 26 males were randomised into either PBC (3 min at − 110 to − 140 °C), CWI (3 min at 9 °C), or control (3 min at 24 °C), with blood samples, heart rate, and blood pressure taken before and after exposure. Cytometric analysis determined that CD8+ T-cell populations were significantly elevated after treatments, with PBC increasing CD8+ T cells to a greater degree than either CWI or CON. Natural killer cell counts were also elevated after PBC, with the increase attributed specifically to the CD56loCD16+ cytotoxic subset. This provides the first evidence for the effect of PBC exposure on redistribution of immune cells. An increase in circulating leukocyte subsets such as CD8+ T cells and CD56loCD16+ natural killer cells suggests that PBC may induce a transient mobilisation of lymphocytes. PBC may thus enable a more efficient trafficking of these cells from the circulation to the site of initial cellular insult from exercise, potentially accelerating the process of cellular recovery. This provides novel evidence on the use of PBC as a recovery treatment and may also have applicability in other clinical settings involving the recovery of damaged skeletal muscle.

Effect of Whole-Body Cryotherapy on Iron Status and Biomarkers of Neuroplasticity in Multiple Sclerosis Women.

The aim of the study was to compare the effect of a series of 20 whole body cryotherapy (WBC) sessions on iron levels and neuroplasticity biomarkers in women with multiple sclerosis (MS) and healthy women. Consent was obtained from the Bioethics Committee at the Regional Medical Chamber in Krakow (87/KBL/OIL/2018; 8 May 2018). The study was registered in the Australian New Zealand Clinical Trials Registry (ACTRN12620001142921; 2 November 2020). The study included 30 people: 15 women with multiple sclerosis (mean age 41.53 ± 6.98 years) and 15 healthy women (mean age 38.47 ± 6.0 years). Both groups attended cryotherapy sessions. Venous blood was collected for analysis before the WBC session and after 20 sessions. In women with MS and healthy women, no significant effect of WBC on changes in the level biomarkers of neuroplasticity was found. There were also no statistically significant differences between the groups of the analyzed indices at the beginning of the study.

Effect of whole body cryotherapy on low back pain and release of endorphins and stress hormones in patients with lumbar spine osteoarthritis.

IntroductionLow back pain (LBP) is the most common ailment in patients with lumbar spine osteoarthritis (OA). There are many methods to treat LBP, such as manual therapy, osteopathy, massage, physical exercise, and physical therapy. The most effective of these are manual therapy and exercises combined with physical procedures, such as whole body cryotherapy (WBCT). Whole body cryotherapy can induce various hormonal adaptations in patients with OA. This is probably the body’s reaction to cold and stress. The purpose of the study was to evaluate the impact of WBCT on β-endorphins, cortisol and adrenaline release, as well as on LBP in patients with OA of the lumbar spine.Material and methodsThe study group consisted of 30 patients with lumbar spine OA who underwent a series of WBCT combined with therapeutic exercises. Before and after the therapy each patient was examined using a visual analogue scale (VAS) and blood samples were collected for laboratory determinations (ELISA).ResultsAfter WBCT, the decrease in LBP measured by VAS was statistically significant (p < 0.0001). The mean value of blood β-endorphin level increased after the therapy but the difference was statistically insignificant (p = 0.10). The mean value of the plasma level of cortisol after treatment increased and the difference was statistically significant (p = 0.0009). The plasma level of adrenalin after treatment increased slightly, but the difference was statistically insignificant (p = 0.08).ConclusionsWhole body cryotherapy combined with therapeutic exercises had a positive effect on LBP reduction in patients with OA. On the basis of these changes, processes that take place in the nervous and endocrine systems are a response to the stimuli of cold and stress. The mechanism of action of extremely low temperatures on the human body is still not fully understood.

The Comparative Effect of Different Timings of Whole Body Cryotherapy Treatment With Cold Water Immersion for Post-Exercise Recovery.

Despite several established benefits of Whole Body Cryotherapy (WBC) for post-exercise recovery, there is a scarcity of research which has identified the optimum WBC protocol for this purpose. This study investigated the influence of WBC treatment timing on physiological and functional responses following a downhill running bout. An additional purpose was to compare such responses with those following cold water immersion (CWI), since there is no clear consensus as to which cold modality is more effective for supporting athletic recovery. Thirty-three male participants (mean ± SD age 37.0 ± 13.3 years, height 1.76 ± 0.07 m, body mass 79.5 ± 13.7 kg) completed a 30 min downhill run (15% gradient) at 60% VO2 max and were then allocated into one of four recovery groups: WBC1 (n = 9) and WBC4 (n = 8) underwent cryotherapy (3 min, −120°C) 1 and 4 h post-run, respectively; CWI (n = 8) participants were immersed in cold water (10 min, 15°C) up to the waist 1 h post-run and control (CON, n = 8) participants passively recovered in a controlled environment (20°C). Maximal isometric leg muscle torque was assessed pre and 24 h post-run. Blood creatine kinase (CK), muscle soreness, femoral artery blood flow, plasma IL-6 and sleep were also assessed pre and post-treatment. There were significant decreases in muscle torque for WBC4 (10.9%, p = 0.04) and CON (11.3% p = 0.00) and no significant decreases for WBC1 (5.6%, p = 0.06) and CWI (5.1%, p = 0.15). There were no significant differences between groups in muscle soreness, CK, IL-6 or sleep. Femoral artery blood flow significantly decreased in CWI (p = 0.02), but did not differ in other groups. WBC treatments within an hour may be preferable for muscle strength recovery compared to delayed treatments; however WBC appears to be no more effective than CWI. Neither cold intervention had an impact on inflammation or sleep.

Combination of whole body cryotherapy with static stretching exercises reduces fatigue and improves functioning of the autonomic nervous system in Chronic Fatigue Syndrome

BackgroundThe aim of this study was to explore the tolerability and effect of static stretching (SS) and whole body cryotherapy (WBC) upon fatigue, daytime sleepiness, cognitive functioning and objective and subjective autonomic nervous system functioning in those with Chronic Fatigue Syndrome (CFS) compared to a control population.MethodsThirty-two CFS and eighteen healthy controls (HC) participated in 2 weeks of a SS + WBC programme. This programme was composed of five sessions per week, 10 sessions in total.ResultsA significant decrease in fatigue was noted in the CFS group in response to SS + WBC. Some domains of cognitive functioning (speed of processing visual information and set-shifting) also improved in response to SS + WBC in both CFS and HC groups. Our study has confirmed that WBC is well tolerated by those with CFS and leads to symptomatic improvements associated with changes in cardiovascular and autonomic function.ConclusionsGiven the preliminary data showing the beneficial effect of cryotherapy, its relative ease of application, good tolerability, and proven safety, therapy with cold exposure appears to be an approach worth attention. Further studies of cryotherapy as a potential treatment in CFS is important in the light of the lack of effective therapeutic options for these common and often disabling symptoms.

Modeling of a Three-Stage Cascaded Refrigeration System Based on Standard Refrigeration Compressors in Cryogenic Applications above 110 K

More and more applications, such as natural gas liquefaction, LNG reliquefaction, whole body cryotherapy and cryopreservation, require cooling in the temperature range from 110 to 150 K. This can be achieved in systems using standard refrigeration compressors, which are reliable and cost-effective, but are subject to certain operating limits. This paper investigates the potential of a three-stage cascaded refrigeration system based on standard refrigeration compressors in this range of temperatures. The investigation takes into account the vital limitations of refrigeration compressors and aims to look for possible refrigerant configurations (taking into account PFCs, HFCs, HCs and HOs); performance limitations such as cooling power temperature and system COP; and the influences of system architecture (single-stage and two-stage compression). The paper investigates whether it is possible to design a three-stage cascaded refrigeration system using standard refrigeration compressors, and if so, at what cost? This investigation shows that the three-stage cascaded refrigeration system can reach the lowest temperature of 127 K with a COP of 0.179, which corresponds to a Carnot efficiency of 0.262. Moreover, systems based on natural refrigerants are found to be advantageous in terms of achieved temperatures compared to those that use synthetic refrigerants. Furthermore, only the application of R50 (methane) is shown to allow temperatures below 130 K to be achieved, and this is possible only in a two-stage compression cascade system. For most of the investigated configurations, the suction pressure must be below atmospheric pressure to thermally couple cascade stages.

The Effect of Repetitive Whole Body Cryotherapy Treatment on Adaptations to a Strength and Endurance Training Programme in Physically Active Males.

Despite its potential merit in sport and exercise recovery, the implications of repetitive Whole Body Cryotherapy (WBC) during training programmes require further review due to the possibility of repetitive cold interfering with long term adaptations. This study investigated the impact of two weekly 3 min WBC sessions (30 s at −60°C, 150 s at −120°C) on adaptations to a 6 week strength and endurance training programme. Sixteen male participants (mean ± SD age 33.4 ± 9.8 years, body mass 82.3 ± 9.8 kg) randomly allocated into WBC (n = 7) and non-cryotherapy control (CON, n=9) groups completed the programme consisting of two weekly strength and plyometric training sessions and two weekly 30 min runs (70% VO2 max). Participants were assessed for body fat, VO2 max, muscle torque, three repetition maximum barbell squat and countermovement jump height before and after the programme. Resistance and running intensities were progressed after 3 weeks. Participants in both groups significantly improved muscle torque (WBC: 277.1 ± 63.2 Nm vs. 318.1 ± 83.4 Nm, p < 0.01, d = 0.56; CON: 244.6 ± 50.6 Nm vs. 268.0 ± 71.8 Nm, p = 0.05, d = 0.38) and barbell squat (WBC: 86.4 ± 19.5 kg vs. 98.9 ± 15.2 kg, p = 0.03, d = 0.69; CON: 91.1 ± 28.7 kg vs. 106.1 ± 30.0 kg, p < 0.01, d=0.51) following the 6 week programme. For the CON group, there was also a significant reduction in body fat percentage (p = 0.01) and significant increase in jump height (p = 0.01). There was no significant increase in VO2 max for either group (both p > 0.2). There was no difference between WBC and CON for responses in muscle torque, 3RM barbell squat and body fat, however WBC participants did not increase their jump height (p = 0.23). Repetitive WBC does not appear to blunt adaptations to a concurrent training programme, although there may be an interference effect in the development of explosive power. Sports practitioners can cautiously apply repetitive WBC to support recovery post-exercise without undue concern on athletes' fitness gains or long term performance, particularly throughout training phases focused more on general strength development than explosive power.

Regular short exposures to cold environment as an adjunct therapy for patients with sleep apnea syndrome (SAS)

Sleep Apnea Syndrome (SAS) is a sleep related-breathing disorder with several features such as systemic inflammation, oxidative stress, cognitive impairment and a poor sleep quality. Patients with SAS have an increased risk of cardiovascular diseases. There is no real effective treatment that prevents and treats all of these illness symptoms. Cooling therapies are often used in sport medicine and in athletes after training and competitions to reduce inflammation, oxidative stress and to enhance sleep quality. In this short article, we hypothesize that the use of cooling therapies (whole body cryotherapy, cold-water immersion…) could be an efficient strategy to facilitate the treatment of SAS patients by reducing the level of systemic inflammation and oxidative stress and enhancing sleep quality.

Modeling of an Innovative Nitrogen-Free Cryotherapy Device

Partial body cryotherapy cabins most often use liquid nitrogen as their cryogenic fluid, which raises safety concerns during operation. In this study, an innovative cryotherapy cabin design is presented, featuring an electric cooling system suitable for producing cold air at −30 °C. The geometry of the designed cryotherapy cabin is evaluated by a thermodynamic modeling which aims at optimizing the circulation of cold air flows inside the cabin. The numerical study is carried out in two successive phases, the first one being necessary to model the pre-cooling phase and to estimate the time required to reach an average temperature close to the set temperature of −30 °C. The second one aims at modeling a 3-min cryotherapy session by taking into account the thermal transfers between the human body and its environment. Results demonstrate the potential benefits of the cold air injection device which has been designed to optimize the thermal transfers and homogenize the temperatures within the therapeutic enclosure. The main innovation of this study is the ability to customize cryotherapy protocols by injecting cold air at different levels through targeting of specific body areas. Further calculations would be required to determine the precise impact of zone-targeted injection on skin cooling.

Thermodynamic Correlation between Actual Temperature and Cryogenic Flow Rate in an Empty Cryosauna

The objective of this study was to monitor the actual temperature in an empty partial body cryotherapy cabin throughout the cooling phase that precedes the cryotherapy session. It was shown that after 9 minutes of cooling, the minimum temperature recorded inside the empty cryosauna was −66 °C while the temperature was set to −140 °C. To further investigate the relationship between the use of nitrogen as a cryogenic fluid and the actual temperature inside the cabin, we used a numerical method and modeled the convective heat transfer for 3 different flow rates (0.01, 0.03 and 0.05 kg/s). According to the simulations, a temperature of about −100 °C may be reached after 3 minutes with a flow rate of 0.05 kg/s against 5 minutes with a flow rate of 0.03 kg/s. With the lowest flow rate, it would be possible to reach −60 °C after 10 minutes. A key assumption is that a too low nitrogen flow does not provide a thermal gradient able to induce the drop in skin temperature required to achieve therapeutic effectiveness.

Experimental and computational thermal analysis of partial-body cryotherapy

During the partial body cryotherapy, human surface is cooled with gas for several minutes. For this, special heat and mass exchanger is used – a cryocabin. From a thermal engineering viewpoint, to improve this empirical treatment, detailed data are needed on the temperature and velocity of the cooling gas, as well as on the biological tissues cooling. For this, current study proposes an improved human, partial body cryotherapy simulation models and study of the partial body cryotherapy heat transfer problem in a single system “equipment-gas-biotissue” using experiment and computer simulation. For the first time the cryoexposure duration up to 420 s was analyzed. The data on the actual cooling gas temperature and velocity distributions, skin and internal biotissue temperature, bioheat flux for the considered typical gas supply mode is obtained. The impact of body mass index, external thermal resistance (body hair) and internal structure of a body parts on cooling dynamics is analyzed. This information is expected to be useful for understanding the effect-exposure correlation of the cryotherapy and in the design of the cryotherapy equipment.

A systematic review and meta-analysis of the effect of whole body cryotherapy on mental health problems

ObjectiveTo give an overview of the nature and methodological quality of studies on whole body cryotherapy (WBC) as add-on intervention for mental health problems. MethodsA meta-analysis according to PRISMA guidelines was conducted (Prospero registration: CRD42020167443). Databases MEDLINE, PsycINFO and the Cochrane Library were searched. Risk of bias was scored according to the Cochrane ROBINS-I-tool to which an extra bias-dimension of allegiance bias was added. Within and between Hedges’ g pooled effect sizes were calculated for the main aspect of mental health measured. Treatment efficacy was examined using a random effects model. Heterogeneity was examined through identification of visual outliers and by I2 statistics. ResultsOut of 196 articles coming up from the search, ten studies met all inclusion criteria, six of which were (randomized) controlled trials. Together these studies report on a total of 294 participants receiving WBC. The within-group pooled effect size for mental health problems is large (Hedges’ g = 1.63, CI: 1.05-2.21), with high heterogeneity (I2 = 93%). Subgroup analyses on depressive symptoms and quality of life (QOL) showed a diminution of heterogeneity to moderate. Effect sizes for depressive symptoms are very large (Hedges’ g = 2.95, CI: 2.44-3.45) and for QOL medium (Hedges’ g = 0.70, CI: 0.15-1.24). The between-group pooled effect size is medium (Hedges’ g = 0.76, CI: 0.17-1.36). ConclusionsResults indicate preliminary evidence for WBC as efficacious add-on intervention for mental health problems, especially depressive symptoms. Further research in the form of RCTs with larger numbers of participants is needed.

Passive Recovery Strategies after Exercise: A Narrative Literature Review of the Current Evidence.

Passive recovery techniques are popular and offer a diverse spectrum of options for athletes and the clinicians providing care for them. These techniques are intended to minimize the negative effects of training or competition, thus enabling the athlete a quicker return to peak performance. Current evidence demonstrates improved athlete recovery with compression garments, cold water immersion, partial body cryotherapy, hyperbaric oxygen, and vibratory therapies. Other popular modalities, such as compression devices, whole body cryotherapy, percussive gun-assisted therapy, neuromuscular electrical stimulation, and pulsed electromagnetic therapy lack convincing evidence concerning athlete recovery. This article seeks to review the current literature and offer the reader an updated understanding of the mechanisms for each modality and the evidence regarding each modality's potential benefit in an athlete's recovery strategy.

The Effectiveness of Computerized Cognitive Training Combined With Whole Body Cryotherapy in Improving Cognitive Functions in Older Adults. A Case Control Study.

Objectives: Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI) are common in elderly population, and constitute a high-risk group for progression to dementia. Innovative, complex, and engaging non-pharmacological methods of cognitive stimulation, implementable at this stage, are needed. The aim of the study was to determine the effect of Computerized Cognitive Training (CCT) combined with Whole Body Stimulation (WBC) on cognitive functions of older adults with SCD and MCI.Methods: A 9-week single-blind pre/post case control trial was conducted. The study enrolled 84 adults aged 60 or older, allocated to one of two intervention groups: EG; CCT with psychoeducation, EG2; CCT with psychoeducation and 10 WBC sessions, or the control group (CG), which comprised patients receiving usual care. The primary outcome measures were cognitive functions evaluated with MoCA scale and several other neuropsychological tools. Depressive symptoms assessed with the GDS scale constituted the secondary outcome measures.Results: The results show evidence for increased performance in the assessment of general cognitive functioning in both EGs (p ≤ 0.05). Significant improvement was also visible in several cognitive domains, such as verbal fluency (EG1 & EG2), learning ability and immediate memory (EG1 & EG2), delayed memory (EG2), attentional control (EG1), and information processing (EG2) (p ≤ 0.05). However, only in the group with combined interventions (CCT + WBC) the participants presented significantly less depressive symptoms (p ≤ 0.05).Conclusions: The results of the study suggest that CCT, especially in combination with WBC, might be a practical and effective method of improving cognitive performance. Moreover, this combination leads to a reduction of depressive symptoms.