BACKGROUND: Post-operative breast cancer patients undergoing chemotherapy frequently experience concurrent upper limb dysfunction and chemotherapy-related cognitive impairment, creating a synergistic burden that complicates rehabilitation. Existing interventions often target these issues in isolation. Baduanjin, a traditional Chinese mind-body exercise, integrates physical movement with cognitive engagement, making it a promising candidate for addressing both domains simultaneously. However, robust evidence from randomized controlled trials (RCTs) was lacking. This RCT aimed to evaluate the effects of Baduanjin on both cognitive performance and upper limb function in this population. METHODS: A two-arm, randomized controlled trial was conducted. Seventy women diagnosed with breast cancer and scheduled for chemotherapy were randomly assigned to either a 12-week supervised Baduanjin exercise group or a control group receiving usual care. Subjective cognitive function was assessed using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog). The neuropsychological test battery included the Auditory Verbal Learning Test (AVLT), the Trail Making Test (TMT), and the Digit Symbol Substitution Test (DSST). Upper limb function was assessed using the Constant-Murley Score (CMS). All assessments were performed at baseline (T0), Week 4 (T1), Week 8 (T2), and Week 12 (T3). RESULTS: Compared to the control group, the Baduanjin group demonstrated significant improvements in total FACT-Cog scores (F 17.710, p < 0.001), perceived cognitive impairments (F 20.085, p < 0.001), and perceived cognitive abilities (F 5.116, p = 0.027). A statistically significant group effect was observed for AVLT6 (F 13.862, p < 0.001). In addition, significant differences were observed between the two groups in shoulder function (p = 0.004, 95% CI 1.09 to 5.59) and ROM (p = 0.002, 95% CI 0.87 to 3.98). CONCLUSION: A 12-week Baduanjin exercise intervention significantly improved subjective cognitive complaints and shoulder function in breast cancer patients undergoing post-operative chemotherapy. The findings support Baduanjin as a safe, feasible, and beneficial adjunct therapy that can concurrently address two prevalent and distressing sequelae of breast cancer treatment.

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