Methods
This study was designed as a prospective, randomized, and assessor-blinded endpoint trial with two parallel intervention groups—COMB and TAU—consisting of a six-week intervention for both groups conducted as a multisite study.We evaluated outcomes at pre-intervention (0 weeks), post-intervention (6 weeks), and follow-up (10 weeks). The Chiba University Research Ethical Review Committee approved this trial (CRB3180015, No. G29027). All procedures were carried out in accordance with relevant guidelines and the regulations of the Declaration of Helsinki.