Exercise as therapy: potential still largely untapped in Switzerland
Physical activity represents an effective form of therapy in combating many chronic non-communicable diseases. In Switzerland, however, the potential offered by exercise as a form of therapy has until now only been utilised to a very limited extent, as researchers from the School of Health Professions and the Winterthur Institute of Health Economics at the ZHAW have demonstrated in a study conducted on behalf of the federal government.
In Switzerland, exercise therapies are primarily offered as part of rehabilitation programmes. However, they are still rarely used during early treatment or as part of long-term follow-up care.
Musculoskeletal complaints, cardiovascular diseases, cancer or diabetes: it is estimated that chronic non-communicable diseases (or NCDs for short), together with mental illnesses, account for more than 80% of all healthcare costs in Switzerland. Physical activity represents an effective form of therapy for the prevention and treatment of NCDs as well as for combating mental illnesses and addiction problems. In the case of certain diseases, for example, it has a comparable effect to that achieved by treating a patient with medication or psychotherapy, as proven in numerous scientific studies. It can also positively influence our quality of life and offer protection against comorbidities.
Exercise programmes almost completely neglected in early treatment
In Switzerland, however, the potential offered by exercise as a form of therapy has until now only been utilised to a very limited extent, as shown by a study conducted by the Research Unit for Physiotherapy, the School of Health Professions and the Winterthur Institute of Health Economics at the Zurich University of Applied Sciences (ZHAW). According to the study completed on behalf of the Federal Office of Public Health (FOPH), exercise therapies are offered in Switzerland as part of rehabilitation programmes and financed in this form under basic insurance coverage. However, during early treatment, i.e. when an individual is diagnosed with an NCD or is exhibiting risk factors for developing an NCD, exercise is still rarely used as a form of therapy. This is likewise true during the provision of long-term follow-up care following the completion of a rehabilitation programme. “Overall, only a small proportion of all people with an NCD are prescribed an exercise programme,” says Karin Niedermann from the ZHAW Research Unit for Physiotherapy and one of the study’s co-leads.
Other countries prescribe exercise
According to the study, other countries are ahead of Switzerland in this respect. For instance, in Sweden, which is considered a pioneer, as well as in Australia, the United Kingdom and France, prescriptions for physical activities can be issued for various diagnoses, i.e. even before an acute event makes a rehabilitation programme necessary. The exercise prescription can be redeemed by patients in the form of a standardised exercise programme. Alternatively, they can receive coaching, for example to enable them to independently plan and put together a regular physical activity regime or to help them find a suitable group-based exercise programme.
Irina Nast, another of the study’s co-leads, is convinced that “more strongly promoting exercise as a form of therapy in the Swiss healthcare system would improve both the health and quality of life of those affected by NCDs, mental illnesses or addiction problems and reduce healthcare costs over the long term”. Among other things, the study’s authors therefore recommend that a national umbrella organisation under the name of “Exercise is Medicine Switzerland” be established, with the involvement of therapeutic and medical societies, educational institutions and the FOPH, to develop a comprehensive concept for exercise as a form of therapy in the Swiss healthcare system.