Reply to: Exercising patient-centredness in prehabilitation programs.

Augmented collective understanding of human nature facilitates stepwise improvement of health care interventions, be it for instance pharmacological or psychological interventions. The very same holds particularly true for interventions like prehabilitation with help of physical exercise training. Underlying here are recent psychobiological understandings combined with critical reflections of leading scientists in new inspiring concepts like Predictive, Preventive, Personalized, and Participatory (P4) medicine. This concept and others pay attention to the uniqueness of individual patients and, for the most based on this uniqueness, the need for individual patient-centredness. The highly appreciated response of colleague Wright adds up to this literature and extends these developments towards the domain of physical exercise training programs. Wright holds, in line with for example Hoogeboom et al., a plea for the uniqueness of individual patients, as well as for patient-centredness in exercise prehabilitation in order to improve patient adherence, especially for the most vulnerable. A plea also for the reinvention of physical exercise training. With respect to this plea, we formerly introduced the concept of “therapeutic validity”, as an important add on for randomized controlled trials and in systematic reviews that, up till then, advised and evaluated methodological quality rather than the content of the physical exercise training program itself. Physical exercise training programs in randomized controlled trials often lack overload, include the younger and more healthy subgroup of patients, and fail to bring out the full potential of their patients. The hereto developed CONTENT-scale urged therapists and researchers to pay more attention to the content of a physical exercise training program and emphasized that this should be tailored to the individual patient, rather than having a ‘one size fits all’ approach. In our pilot study, patients were offered physical exercise training during the period in which they underwent neoadjuvant chemoradiotherapy (NACRT). This was