Hula practitioners have long touted the health benefits of Hawaii’s signature dance form. Now, thanks to a new study on the rehabilitative potential of hula for heart patients, they have the science to support their claims.

According to the five-year Hula Enabling Lifestyle Adaptation study conducted by the University of Hawaii John A. Burns School of Medicine and the Queen’s Medical Center in conjunction with Halau Mohala Ilima, a couple of standard hula dance sets provides a workout comparable to pickup basketball or tennis.

"When you watch accomplished hula dancers, their movements look effortless," said investigator Mele Look. "But what they are doing requires a lot of strength and energy."

As part of their research, investigators outfitted accomplished hula dancers with high-tech monitors to track the amount of energy expended while they danced auana (modern) and kahiko (ancient-style) dance sets.

The results showed that low-intensity hula had a Metabolic Equivalent (MET) value of 5.7, just higher than fast ballroom dancing (5.5) but lower than a pickup basketball game (6.0). High-intensity hula had a MET value of 7.5, falling between tennis (7.0) and a competitive basketball or volleyball game (8.0) in energy expenditure. An average hula workout recorded a MET value of 6.6.

The implications for those recovering from a heart attack or heart surgery are promising, according to study investigators.

Having proved that a hula-based exercise program could help patients reach the same levels of energy exertion as traditional cardiac rehabilitation therapy, the study opens the door for a uniquely Hawaiian cardiac rehabilitation program that promises not only physical benefits but cultural significance, social support and other powerful motivators, said co-chief investigator Keaweaimoku Kaholokula.

Kumu hula Mapuana de Silva, who worked with investigators to adapt regular hula classes to the requirements of the study and conducted classes for study participants, said the results confirm what many in the hula community already knew.

"For those of us who dance hula, we knew what the results would be before we started," de Silva said. "But what the findings revealed was more profound than we realized. The participants came in with an open mind and they really got into it, and not just the dancing but the study of hula as well. They gave it 100 percent. It was pretty amazing."

As co-chief investigator Todd Seto of Queen’s noted, post-hospitalization cardiac rehabilitation programs are proven effective in reducing the risk of death from heart-related ailments. However, Seto said, such programs are no longer offered in Hawaii hospitals, and even when they were, few doctors referred patients to them and even fewer patients bothered to attend.

Kahea Rivera, a study investigator and cardiology fellow at Queen’s, said the social, psychological and spiritual benefits many participants experienced during the study only added to the physical benefits produced by the tempo, style and movements of the dance sets.

"And what would you rather be doing," Rivera asked, "running on a treadmill or dancing hula?"

Pilot programs that use hula as part of overall cardiac rehabilitation are already in place in Papakolea and Kokua Kalihi Valley. Results will be compiled and examined at the end of the year.