Occupational Therapy Intervention to Mitigate Chemotherapy-Induced Cognitive Impairment Among Breast Cancer Patients: A Systematic Review

IMPORTANCE: Evidence regarding the impact of occupational therapy intervention, with or without transcranial direct current stimulation (tDCS), on chemo-induced cognitive impairment (chemo brain) among women with breast cancer, is limited. OBJECTIVE: To analyze the impact of occupational therapy interventions, with or without tDCS, on mitigating chemo brain among women with breast cancer and to determine how these interventions affect cognitive functions, occupational performance, and quality of life. DATA SOURCES: PubMed/MEDLINE, Scopus, ScienceDirect, and SciELO. STUDY SELECTION AND DATA COLLECTION: A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Sources included clinical trials, observational studies, and systematic reviews published between 2000 and 2024, focusing on women with breast cancer experiencing chemo brain and receiving occupational therapy with or without tDCS intervention. Study quality was assessed using risk-of-bias assessment tools, such as the Critical Appraisal Skills Programme or the Cochrane tools, depending on the study design. FINDINGS: The results indicate that occupational therapy interventions show a positive trend in improving occupational performance, cognitive function (memory, attention), and quality of life among women with breast cancer. Although tDCS showed potential, studies were limited and primarily focused on people with other conditions. The combination of technological and occupational interventions stood out for its positive impact on functional recovery. CONCLUSIONS AND RELEVANCE: Occupational therapy interventions are effective in mitigating the sequelae of chemo brain among breast cancer patients, improving functionality and quality of life. tDCS is a promising but underexplored treatment that requires further specific research with this population. Plain-Language Summary: This systematic review was conducted to assess the effects of occupational therapy, with or without transcranial direct current stimulation (tDCS), on the sequelae of chemotherapy after breast cancer treatment. The analyzed studies indicated that occupational therapy interventions show a positive trend in improving occupational performance, cognitive function (memory, attention), and quality of life of women with breast cancer.