Heartwise is primarily concerned with prescribing doses of aerobicand toning exercise, based on the FITT principle that confer and maintain measurable physiological changes known to reduce chronic illness symptoms and mortality.

Aims of the Service

Cardiac rehabilitation is defined by the World Health Organization (1) as: “.The sum of activities required to influence favorable the underlying cause of the disease, as well as the best possible, physical, mental and social conditions, so that they (people) may, by their own efforts preserve or resume when lost, as normal a place as possible in the community. Rehabilitation cannot be regarded as an isolated form or stage of therapy but must be integrated within secondary preventions services of which it forms only one facet” The service provides a comprehensive Cardiac Rehabilitation programme to the population of South Tipperary. The Cardiac Rehabilitation Service provides support and education via a service that includes:

Cardiac Rehabilitation programs are designed to limit the physicaland psychological effects of cardiac illness, reduce the risk of sudden death or re-infarction, control cardiac symptoms, stabilize or reverse the atherosclerotic process and enhance the psychosocial and vocational status of selected patients.

Scope of the Service

Heartwise staff

A minimum of one instructor will be present in each class at all times. This instructor must be BACPR (British Association of Cardiac Prevention and Rehabilitation), First Aid and Defibrillator qualified.

The principles underlying safe and effective exercise prescription for individuals with coronary heart disease

Safety is the paramount consideration for the delivery of the program.

The criteria for accepting clients are as follows,

Contraindications to exercise.

Criteria for assessing suitability to exercise

Reasons for referring a client to their GP

Aims and Objectives

The aims and objectives of Heartwise are to complement the role of the primary healthcare team. Heartwise will continuously reflect on the partnership with all relevant bodies including, local HSE, GP’s, Phase III coordinator’s and any private entities providing a coronary care service.

Heartwise will
Before starting exercise sessions each individual should have advised the instructor of,
During any exercise session each individual will advise the instructor of


If any person has been prescribed with GTN spray this should be brought to the class even if not used on a regular basis. The classinstructor should also be informed.

Key Principles of each class delivered

Key Principles of each class delivered

Warm Up

The warm up, inclusive of pulse raising, mobility and preparatory stretching should be 15 minutes in duration.By the end of the warm up period participants should achieve a heart rate withing 20 bpm below the lower end of their training heart rate of if RPE is being used no higher than 3 on the CR-10 scale and 10 or 11 on the 6 – 20 scale.

Conditioning Component

Depending on the fitness level of individual participants, clients perform differing durations of continuous aerobic exercise before spending time in active recovery. A less able client would do one aerobic station followed by one toning station where as a fitter client may complete four aerobic stations before performing a toning activity. The conditioning component will last at least 30 mins.


The exercise regimen may be progressed through various combinations of increasing duration, frequency or intensity of training. However, as endurance training is the main objective of the program an increase in the duration of aerobic work is the most important method of progressing a program.

Monitoring Intensity

Participants are told to make a mental note of their rating of perceived exertion towards the end of each bout of CV work, so they can write it down in their program card or report it to the instructor. Spot checks should be carried out by the instructor throughout the class.

Cool Down

The cool down should be more gradual to reduce the risk of increased hypotension and reduce high levels of catecholamines that increase the risk of arrhythmias. The cool down should last for 10 minutes, returning heart rates to pre-exercise levels.


There are no significant differences in training needs between individuals with coronary heart disease compared with apparentlyhealthy individuals. Proprioceptive neuromuscular facilitation stretches are not generally appropriate due to the isometric contraction involved in the procedure leading to increased blood pressure.

New Client’s

New clients will be thoroughly familiarized with the format of the class to avoid confusion. The instructor will monitor new clients to ensure their safety and enjoyment of the class.

Hours of operation

The Cardiac rehabilitation service is available from Monday to Friday and is open from 8am to 8pm. Closing for Lunch from 1pmto 2pm

Programme records and confidentiality

Before joining the programme, referred individuals agree to the transfer form, that includes personal and medical information being given to Heartwise staff. Maintaining the confidentiality of the information supplied becomes the responsibility of the instructor and this must be taken seriously. Any information transferred on to computers must be password protected. The manager will have overall responsibility for confidentiality of all records. If the programme ceases any forms should be returned to the participant or to whoever initiated the referral. All information stored on computer should be deleted.


Infection Prevention

The service will be delivered in accordance with and compliance to Heartwise Infection Prevention Policies. All machines will be cleaned before the start of each class. Each machine will be cleaned when the participants move onto a new machine within their training pod and before entering a new pod.


Both directors are responsible for the facilities operational and financial accountability for service delivery.