"The spark ignites in everyone": How targeted exercise improves quality of life

Certified oncological training and exercise therapy (OTT) is relatively new. In Switzerland, it has so far only been offered at the ZIO Winterthur. What is the aim of this form of therapy?

Dirk Scharr: The primary aim is to improve the quality of life of cancer patients. Even in phases of illness, exercise and sport can contribute a great deal to well-being, as is becoming increasingly clear in clinical studies. This has long been used specifically in rehabilitation. OTT now starts much earlier, namely in parallel with other oncological therapies, often directly after diagnosis. Many symptoms triggered by cancer or side effects of oncological therapies can be reduced or even prevented if patients receive an individually tailored training program that they complete under close therapeutic supervision. This requires specially trained physiotherapists like Moritz Rose.
Moritz Rose: We work very closely together. Only after Dirk Scharr and his team have carried out an initial medical assessment with the patients do they come to us in the OTT. We then also carry out various tests first so that we can see how up-to-date the person's endurance, muscular ability and sensorimotor skills are. Only then do we develop a therapy program and define the goals. And we do this together with the patient.

Who is oncological training therapy suitable for?

Scharr: In principle, anyone with an oncological disease can benefit from OTT. There are few treatment situations in which OTT cannot be started or should be paused. For example, if certain blood values fall below certain limits or, of course, in the case of an infection or directly after an operation. Even directly after chemotherapy, you wait a few days before doing targeted exercise therapy. All of this is taken into account, which is why the medical assessment and continuous medical support are important.

"Even in phases of illness, exercise and sport can contribute a great deal to well-being."
Dr. med. Dirk Scharr

What specific symptoms can be alleviated?

Scharr: There are many. We have good scientific evidence of the positive effect of OTT on anxiety, depression, sleep disorders and chronic fatigue syndrome, which can occur very frequently during the course of an oncological disease and therapy. There are also positive effects in terms of strength, endurance and mobility. Specific problems such as incontinence or lymphoedema can also be treated with OTT. We will learn more about whether the effectiveness of oncological measures such as radiotherapy or chemotherapy can be improved by exercise from various studies in the future.
Rose: I am impressed by the positive experiences we have with patients who suffer from fatigue. This extraordinary tiredness can reduce quality of life enormously. When we work carefully with exercise therapy, we often see amazing effects. Just today I had a patient who greeted me with the words that he hadn't felt this good for ages. He had only had one session.

How often do you train and how long does the therapy usually last?

Rose: The therapy involves one hour of training twice a week for three months. There are always intermediate stages during this time. We discuss together which goals have been achieved and how the therapy should be adapted in the further course if necessary.

Many people with cancer can hardly imagine doing sport or are afraid that they could harm themselves. How do you counter such reservations?

Rose: The most important thing here is certainly the medical assessment. The attending physicians are saying: You can, you can do this. That gives the person concerned a sense of security. And then, of course, we proceed very carefully and respond specifically to each person. We start with an individually appropriate load. I've noticed that many patients have to learn to make an effort again, so to speak. Of course, we want to challenge them, but we don't want to overload them. This is also not easy for the patients themselves. It's difficult to accept that your own limits have shifted so much with the illness. That's why you need this close support.
Scharr: Incidentally, safety is also one of the reasons why we offer and carry out this certified form of therapy here at the ZIO. It should take place in a medical facility so that patients can be sure that medical professionals are always within reach. The planning and implementation of the training is adapted to the individual situation and performance and is accompanied by a therapist.

"I'm impressed by how the patients stick with it and come here twice a week to train. I think that shows how good the training is for them."
Moritz Rose, certified OTT therapist

What has been your experience with the OTT in Winterthur so far?

Scharr: The spark is ignited in everyone. It's remarkable: when people come out of OTT, they are often in a really good mood. This is transferred to those around them and to those of us treating them. The key word here is "self-efficacy": the patients take an active role in their treatment, they can influence the further course themselves.
Rose: Yes, I feel the same way. Most of them are extremely motivated and despite the incredible strain that cancer patients experience overall, I find them to be in a good mood and happy in training therapy. I'm impressed by how much most of them stick with it and come here twice a week to train. I think you only do that under such circumstances if it's really good for you.