Five years ago, the University of Ottawa Heart Institute launched the Heart Wise Exercise (HWE) program in the national capital to both assist people with heart disease and prevent its onset. The program has since broadened its mandate to prevent or limit the effects of living with a chronic health condition—particularly stroke and diabetes—as well as its geographical reach. Expansion to the Greater Toronto Area in September brings the total number of Heart Wise Exercise programs to 235, serving more than 12,500 Ontarians.The idea behind HWE is to help anyone diagnosed with heart disease or another chronic condition incorporate exercise into an overall fitness routine, explained Jennifer Harris, Regional Manager of Cardiovascular Disease Prevention and Rehabilitation Outreach at the Heart Institute. The program began in Ottawa in 2007 and soon broadened its reach to the rest of eastern Ontario, where there is a high prevalence of heart disease.
“Heart Wise Exercise is not meant to replace rehabilitation programs but to augment them and connect people with a lifelong fitness partner in their community,” she said. “It’s also a program focused on prevention that anyone wishing to stay healthy can participate in.”
Run through partner municipal community centres and private fitness facilities, HWE classes are approved by the Heart Institute as safe and suitable for people with heart disease and other chronic conditions.
Expansion to the Greater Toronto Area in September brings the total number of Heart Wise Exercise programs to 235, serving more than 12,500 Ontarians.
“Patients who graduate from cardiac rehabilitation are given an exercise prescription by their physiotherapist,” Harris explained. “But some people are intimidated by going to a regular gym where they feel they might not fit in wearing skimpy outfits and getting down on the floor to do sit-ups. We realized we needed a better way to show them which fitness classes are available and appropriate for them.” Heart-friendly classes at HWE-partner sites are identified with the HWE okay-sign logo and symbol.
The Heart Institute offers a one-day workshop for fitness instructors, giving them background on cardiac disease, stroke and diabetes, along with exercise guidelines specific for people with these conditions and how to incorporate them into fitness classes. Instructors, in turn, ensure class participants are shown proper warm-up and cool-down techniques and how to self-monitor during exercise so, as Harris explained, “They listen to their bodies and don’t push themselves to the limit.” In addition, all HWE locations have an emergency plan, phone access to a local paramedic service and an automated external defibrillator on site.
The HWE program is offered on land and in water, and covers the gamut from basic walking or chair-based classes to more advanced aerobic and strength-training classes that have been slightly modified to meet the Heart Institute’s criteria.
“One of the nice things about the program is that the Heart Institute has reached out within the community to find places where people can stay active after they’ve completed 12 weeks of rehab,” said Anita Findlay, Fitness Program Coordinator for the City of Ottawa’s Recreation and Culture Department.
The Goulbourn Recreation Complex in the Ottawa suburb of Stittsville, where she is also a fitness instructor, offers two HWE classes, one land-based and the other in water. Freedom 55 is geared to seniors and encompasses muscle toning, cardiovascular conditioning, and some flexibility and balance training. Aqua Lite is for retirees, arthritis sufferers and people with back or joint problems. It provides a low-impact workout focused on cardiovascular, strength and endurance training.
Each of the classes always has participants who self-identify as having cardiovascular disease or high blood pressure. However, rather than singling them out during a session, the instructor reminds everyone in the class to regularly check their pulses to ensure they are within their own target heart rates.
“The onus is still on the participants to self-monitor based on the exercise prescription they received from their doctors or physiotherapists, but we regularly remind them to not overexert and take it down a notch if they find themselves breathless,” Findlay explained.
She notes that motivating people to attend class does not seem to be a problem. “In one class I led, I realized one person was missing but was back the following week. It turned out he had had to get a coronary stent inserted just 10 days before!”
That commitment by thousands of participants in Ontario, along with the partnership between the Heart Institute and public and private fitness facilities, has been the program’s greatest success to date.
In fact, partnership has been an important part of Heart Wise Exercise from the start, and the recent expansion into Toronto was made possible by funding from the Ontario Trillium Foundation to a team including the Heart Institute, the Cardiac Health Foundation of Canada, the Toronto Rehab Institute, the YMCA of Greater Toronto, Toronto Emergency Medical Services and the Mikey Network.
“We provide the clinical expertise and the fitness leaders provide their expertise and passion for getting people exercising safely, and in the end, the community really benefits,” said Harris. The greatest challenge is increasing awareness about the program within the medical community. “The goal,” Findlay added, “is to get physicians knowing how the Heart Wise program works and get their patients to look for the logo.”
Harris said that the next step for HWE would be to take the program province-wide, though it has already caught the attention of the Public Health Agency of Canada, which promotes physical activity as part of its mandate. “For now, Heart Wise funding is grant-based, and I think it’s important to acknowledge the commitment of the Heart Institute to developing and supporting prevention programs like this one.”
“Ultimately,” she concluded, “anyone can take a Heart Wise Exercise class, especially if they’re concerned about their heart health or just beginning an exercise program.”