The HeartSmart programme helps heart attack victims take charge of their health, writes Claire O'Connell
As toe-tapping music starts to play over the speakers, a group of around 25 men and women stride purposefully around a university sports hall, many chatting animatedly in twos and threes as they warm up.
But this is not just a social gathering. This is HeartSmart, a new programme that encourages people who have had a heart attack to take charge of their health in the longer term.
Appropriate exercise can help the heart adapt after a coronary event, explains HeartSmart's director, Dr Catherine Woods, a lecturer in exercise psychology and public health at Dublin City University (DCU).
"If an individual has damaged part of the heart, the remainder of the heart will become healthier because of the exercise," she says.
Currently, a person who has had a heart attack can undergo exercise rehabilitation in the hospital setting as they recover. "The hospital provides an exercise-based intervention where you work with the nursing staff or physiotherapists, and they do an exercise programme for up to 10 weeks," says Woods. "But after that, there's nothing. It's like 'you have done really well, we think you should continue exercising', but there's no formal programme that they could continue on to."
This gap is where the HeartSmart programme can provide a new link in Ireland between hospitals, academics and the community, according to Woods.
Last November, the collaboration between DCU and the Mater, Beaumont and James Connolly hospitals started a pilot programme of twice-weekly exercise classes at the university's sports club for people who want to continue their cardiac rehabilitation.
Participants, who pay €5-€6 per class, first fill in a questionnaire about how they felt since the last session. They can also check their blood pressure and speak to medical physician Dr Noel McCaffrey about any concerns.
Then they do a guided circuit of different exercises at their own pace, learning how to gauge whether they are exercising appropriately. "We teach self-regulation skills that allow them to identify what they can do. We use the phrase 'talk, whistle or sing': if you can sing, you are probably going a little bit easy; if you can talk, you are about right; and then if you can whistle then that's okay too," says Woods.
"Our ultimate aim is to get people into the independent exerciser phase, so they can walk down to the shops and not be afraid that halfway there they are going to overdo it," she explains.
Meanwhile, the group aspect can help motivate people into exercise, according to Marian Claffey, a senior physiotherapist in cardiac rehabilitation at James Connolly Memorial Hospital.
"It's difficult to continue on your own," she says as she works with the class. "The group is beneficial, they keep going with it."
At the end of the class there's time for a cup of tea, which enables the HeartSmart staff to ensure everyone feels well after the session. And it also provides an important social outlet, says Woods.
"For a lot of older adults that I have been chatting to, the risk of social isolation is pretty high," she explains. "Just having an avenue where they can meet other people who are in the same condition as themselves is invaluable."
Moving longer term rehabilitation exercise programmes into the community could ultimately help decrease the burden on hospitals, according to Woods. And linking with the universities provides opportunities to train students in taking classes and to research the most practical ways of offering community-based rehabilitation.
"This is a link with exercise scientists who are able to take information about physical activity in its broadest sense and then use that towards developing public health and health promotion of individuals," she says.
As the programme grows it will also offer seminars on topics such as nutrition, returning to work and coping with a changed lifestyle.
"It's not just about doing the exercise, it's about learning more about how to manage your condition," says Woods.
Broadcaster Bill O'Herlihy will officially launch the HeartSmart programme later this month, and the team is talking to the Health Service Executive (HSE) about possibilities for developing the programme further.
"This is a model that could be used in other areas of the country," says Woods.
"We are hoping to extend it to people who have heart disease but who have never undergone a coronary event, so the idea would be that it would be preventative.
"But in the first instance we are working with the high-risk group who have already had coronary events. And if we can give them back control over their own life, then we have achieved a lot," she says.