Ka Wai Ola - Office of Hawaiian Affairs, Volume 26, Number 12, 1 December 2009 — Hula study for heart health is launched [ARTICLE+ILLUSTRATION]

Hula study for heart health is launched

By Liza Simon OHA Public affairs The oft-repeated proverb that "hula is the heartbeat of the Hawaiian people" is taking on a new twist in a medical study that is looking at whether Hawai'i's traditional dance ean give a new lease on life to someone who has undergone open-heart surgery. So far, those who are behind the project, known as Hula Empowering Lifestyle Adaptations, or HELA, are optimistic. Kumu hula Māpuana de Silva, renown for leading Hālau Mohala 'Ilima to perennial Merrie Monarch success, is a cultural coordinator and instructor for the hula-based program. She praises participants in the premier HELA session earlier this year for aeeomplishing a feat as commendable as ascending hula's most prestigious stage. "They all recognize that they have been to the edge of life. They've faced the fear of dying. They are determined and motivated to never go through that again. If hula ean be the catalyst that will make them realize that their heart is a muscle and they have to keep it fit, then they have learned a great lesson," said de Silva. HELA is a joint project of The Queen's Medical Center and the Department of Native Hawaiian Heahh at the University of Hawai'i John A. Burns School of Medicine (JABSOM). Queen's cardiologist Dr. Todd Seto, principal investigator for the study, said HELA was designed with the help of Dr. Frederic Pashkow, a national expert in cardiac

rehabilitation. Seto happily reports that Pashkow's preliminary studies indicate that the medically supervised activities of HELA raised the oxygen intake of participants, an important physiological goal that adheres to national standards for heart care. But could HELA exceed conventional approaches in meeting the ultimate goal of improving quality and length of life for someone who has experienced a heart attack? This is the hope that is being put to the test in the yearlong HELA project, whieh receives funding support from the Nahonal Institutes of Heahh. Seto said that HELA aims to help in recovery not only from physical pain but also from the emotional devastation of a heart attack. "Unfortunately, the standard used today by hospitals is to bring the person back into the hospital for weekly sessions of supervised exercise on treadmill machines. This approach just doesn't resonate with mueh of the Hawai'i populahon and the response is typically poor," said Seto, stressing that HELA was conceived as a way to tailor cardiac rehab to meet a broader range of patient needs — physical, spiritual, social and psychological. Seto said HELA may not only turn out to be more fulfilling for patients, it may also eventually offer care that is more accessible than the treadmill programs. He said such programs have been cut by Hawai'i hospitals, where they've been deemed too costly and laborintensive to maintain during the eeonomie downtown. In addition, Seto said certain ethnic groups — including Native Hawaiians — are less likely to be

referred upon discharge from heart surgery to any form of out-of-hospital cardiac rehab service even though these very same groups have a greater risk for developing serious complications from cardiovascular disease and are more likely to experience heart attacks at a mueh younger age, when rehab is shown to be most effective. "We were all looking for ways to address these disparities in Hawaiian heart care," said medieal researcher Mele Look with JABSOM's Department of Native Hawaiian Heahh, describing the impetus behind HELA. Look said she began brainstorming with her Queen's colleagues on a project that would test the effectiveness of cultural interventions offered to any Hawai'i resident still in the iniīial steps of recovery after heart surgery. Look had reason to believe that hula could be the basis of such a program and that Māpuana de Silva was the right person to connect the integrity of hula heritage with the goals of cardiac rehab. A longtime member of de Silva's halau, Look said the award-winning kumu has always impressed on her haumāna that hula has healing powers. "You enter (de Silva's) hālau practice, and you are supported by the sharing and love of your hula brothers and sisters," she observes. At the same time, Look was confident that de Silva would have no trouble meshing her teachings with scientific standards: de Silva has a degree in physical education and had already developed a curriculum that integrates stretching exercises and other principles of injury prevention. De Silva was excited to be tabbed for the HELA study. "I have known

all along that hula is good for your health, because it works on so many levels, opening us to Hawaiian culture, to spiritual growth and to nature," said de Silva, adding, "I never imagined that science would relax to this point of looking at what we know from intuition. This is a milestone for science and culture." Both de Silva and Seto agree that science and culture have found a good marriage in the HELA project. The sessions are held three times weekly at Queen's Medical Center, with kumu providing instruction and nurses and doctors present to take vital signs at set intervals. In the debut class, students with memories of gurneys, ambulances and the ER still fresh in their minds, learned to stretch and move rhythmically to the strains of "Puamana," the 'auana mele chosen by de Silva, because she believed its lyrics written by Aunty Irmgard Aluli about memories of a Lahaina home provide a sense of universal comfort. "When I passed out the sheets, participants couldn't wait to sing," said a pleased de Silva. "We all cried the last day of class," recalls de Silva, adding that the tears were fromjoy. "The experience of hālau as family was intensified by the sharing of a true life and death connection," she said. What is important to de Silva is the fact that students leave HELA with a lasting joy of reconnecting with their bodies. "As long as they eonhnue on this path, it doesn't matter if it's with hula or something else that they do to take good care of themselves," she said. Data on the HELA class participants will eventually be compared to that collected a from a control group, whieh is receiving standard cardiac rehab. Results of the study will be published in a medical journal. Dr. Seto is confident that this

spotlight on the eonneehon between hula and heart health will be helpful to Hawaiians and non-Hawaiians alike. "I've learned that hula means so many different things to different people. This makes it a more adaptable activity — something that will likely to be continued and sustained over a lifetime," said Seto. ■

Get involved The HELA Project is starting a new session in Januaryand is seeking participants. To be eligible, you must be at least 18 years olel anel in recovery from recent open-heart surgery. For more information, eall Malia Young at 545-8768.

[?]