Objective: To describe baseline motor, non-motor, and psychosocial characteristics in a randomized, delayed-start hula intervention trial for Parkinson’s disease (PD).
Background: Culturally grounded movement practices may support physical,1 emotional,2 and psychosocial well-being in PD. Hula, an indigenous Hawaiian practice integrating rhythmic movement, hand-foot coordination, breath, and storytelling, may offer therapeutic elements distinct from conventional PD exercise programs. Following a recent pilot study (Shuman et al., unpublished) demonstrating feasibility and acceptability, a randomized delayed-start trial launched in January 2026. Participants in the intervention group receive 24 weeks of hula, while the wait-list control group completes 12 weeks. Balance, non-motor, wellness, self-efficacy, and subjective voice measures were selected based on pilot cohort feedback, reflecting outcomes identified as most meaningful.
Method: Of 150 individuals with mild to moderate PD screened, 37 enrolled and were randomized to intervention (n=17) or wait-list control (n=20). Unequal group sizes reflected attrition. Baseline assessments included demographics, PD history, balance testing, MDS-UPDRS Part III, and five questionnaires: MDS-NMS-Q,3 PDQ-39,4 Warwick-Edinburgh Mental Well-being Scale (WEMWBS-14),5 Self-Efficacy to Manage Chronic Disease Scale (SEMCD-6),6 and Voice Handicap Index-10 (VHI-10).7 Group differences were analyzed via Wilcoxon rank-sum tests.
Results: Among 37 participants (19 male, 18 female; Asian American=20, White=12, NHPI=5), the average (SD) age was 68.8. ± 8.6 years. Mean (SD) age of symptom onset and diagnosis were 60.8 ± 11 and 63.1 ± 10.2 years. Average Hoehn and Yahr stage was 2.23 ± 0.58. Median (IQR) MDS-UPDRS III was 31 (28-41). Median (IQR) non-motor and psychosocial scores were: MDS-NMS-Q 42 (30-56), PDQ-39 SI 19.2% (12.8-31.4%), WEMWBS-14: 50 (45-56), SEMCD-6: 45 (32-50), and VHI-10 8 (5-18). These values indicate mild to moderate challenges in well-being, self-efficacy, and voice function. No significant differences (p>0.05) were observed between groups.
Conclusion: Baseline equivalence between groups across motor, non-motor, and psychosocial measures supports the validity of subsequent analyses examining hula intervention effects. The trial is in progress, and future outcomes will be reported upon completion.
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2. Mehta A, Dugani P, Mahale R, et al. Garba Dance Is Effective in Parkinson’s Disease Patients: A Pilot Study. Parkinsons Dis. 2024;2024:5580653. Published 2024 Jun 20. doi:10.1155/2024/5580653
3. Weintraub D, Chaudhuri KR, Schrag A, et al. Validation of the International Parkinson and Movement Disorder Society Non-Motor Symptoms Questionnaire (MDS-NMS-Q). Mov Disord. 2025;40(6):1037-1046. doi:10.1002/mds.30202
4. Jenkinson C, Fitzpatrick R, Peto V, Greenhall R, Hyman N. The Parkinson’s Disease Questionnaire (PDQ-39): development and validation of a Parkinson’s disease summary index score. Age Ageing. 1997;26(5):353-357. doi:10.1093/ageing/26.5.353
5. Tennant R, Hiller L, Fishwick R, et al. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health Qual Life Outcomes. 2007;5:63. Published 2007 Nov 27. doi:10.1186/1477-7525-5-63
6. Melin J, Fors A, Jakobsson S, Krabbe D, Björkman I. Self-Efficacy to Manage Chronic Disease (SEMCD) scale: translation and evaluation of measurement properties for a swedish version. Arch Public Health. 2023;81(1):2. Published 2023 Jan 4. doi:10.1186/s13690-022-01022-x
7. Rosen CA, Lee AS, Osborne J, Zullo T, Murry T. Development and validation of the voice handicap index-10. Laryngoscope. 2004;114(9):1549-1556. doi:10.1097/00005537-200409000-00009
To cite this abstract in AMA style:
R. Shuman, E. Krening, K. Tolentino, M. Yee, K. Thai, M. Faouzi, M. Bruno. Hula as an Integrative Movement-Based Therapy: Baseline Cohort Characteristics [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/hula-as-an-integrative-movement-based-therapy-baseline-cohort-characteristics/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/hula-as-an-integrative-movement-based-therapy-baseline-cohort-characteristics/