Objective: Design a culturally-based movement program to improve the experience of living with Parkinson’s disease.

Background: Prior research has shown that dance therapy enhances the mobility and quality of life in individuals with Parkinson’s disease (PD). While studies have shown the benefits of the Native Hawaiian dance of hula for hypertension and cancer, there is an opportunity to explore the feasibility and effectiveness of a hula program specifically designed for PD (1).

Method: Our team from the Parkinson’s and Movement Disorder Center at The Queen’s Medical Center in Honolulu, HI interviewed 3 groups to inform the development of our program. Key informants (adults with PD or caregivers with hula experience, n=4) discussed the challenges of hula from the perspective of PD. Kumu hula (n=3), or master hula practitioners, discussed balancing cultural authenticity with practical adaptations. We used qualitative analysis techniques for both groups to summarize and identify key themes. Instructors at Dance for PD® (2) allowed us to observe classes and provided advice on creating a safe and effective dance program for PD through informal interviews.

Results: All groups agreed that hula could provide physical, mental, and spiritual benefits for PD and provided guidance on safety concerns. Key informants shared experiences of dancing to a tempo too fast (fell behind steps) or too slow (led to freezing and stiffness) and suggested adjusting the tempo as needed and using repetition to build self-confidence. They recommended reinforcing associations between lyrics and hula hand gestures to facilitate smoother movement. Kumu hula suggested teaching choreography with hula footwork patterns that keep both feet on the ground for stability and facilitating cultural practices like traditional chanting and singing, which promote participation and cognitive engagement. Dance for PD® instructors highlighted the role of imagery as a movement cue and recommended playing music with strong beats during warm-up to orient participants to use rhythm to guide movement. They suggested initially teaching hand gestures while seated then shifting focus to balance when transitioning to standing hula. All agreed on using chairs for seated modifications and support while standing.

Conclusion: With feedback from key informants, Dance for PD® instructors, and kumu hula, we designed a beginner-friendly and culturally credible hula program for PD.

References: 1. Kaholokula JK, Look M, Mabellos T, Ahn HJ, Choi SY, Sinclair KA, Wills TA, Seto TB, de Silva M. A Cultural Dance Program Improves Hypertension Control and Cardiovascular Disease Risk in Native Hawaiians: A Randomized Controlled Trial. Ann Behav Med. 2021 Oct 4;55(10):1006-1018. doi: 10.1093/abm/kaaa127. PMID: 33677520; PMCID: PMC8489304.

2. Westheimer, O., McRae, C., Henchcliffe, C. et al. Dance for PD: a preliminary investigation of effects on motor function and quality of life among persons with Parkinson’s disease (PD). J Neural Transm. 2015; 122: 1263–1270. https://doi.org/10.1007/s00702-015-1380

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MDS Abstracts - https://www.mdsabstracts.org/abstract/designing-a-cultural-dance-program-for-people-with-parkinsons-disease/