Patients in the experimental group received an orientation on the web-based DMT program before chemotherapy, along with a single face-to-face traditional education session on physical activity. Participants were encouraged to complete training sessions three times per week, with each session lasting at least 70 min. Each DMT training session was divided into four components: (1) Proprioception; (2)Warm-up and stretching techniques; (3) Main part; (4) Relaxation.

Alexithymia was assessed using the Chinese version of the Toronto Alexithymia Scale (TAS), a self-reported outcome measure [30-31]. The TAS consists of 20 items covering three key domains: difficulty in identifying and discriminating emotional cues, difficulty in verbally expressing emotions and feelings, and externally oriented thinking. Each item was rated on a 5-point Likert scale, ranging from 1 to 5, resulting in a total score range of 20 to 100, with higher scores indicating greater alexithymia.

A breast cancer comprehensive frailty scale (BCCFS) was developed to assess frailty across three domains: deterioration in body function and mobility, negative emotional states, and cognitive impairment. The BCCFS comprises 16 items and has demonstrated strong psychometric properties, with a Cronbach's alpha of 0.91, indicating excellent internal consistency, and a test-retest reliability coefficient of 0.60 [32]. The validity and reliability of the BCCFS have been well established. Responses to each item were recorded on a five-point Likert scale, with higher scores indicating greater perceived frailty.