Date Presented 4/19/2018
This study provides quantitative data showing the functional limitations of deaf and hard-of-hearing individuals in instrumental activities of daily living (IADLs) before and after an adapted 8-wk yoga intervention. IADL performance was measured using the Performance Assessment of Self-Care Skills.
Primary Author and Speaker: Sarah Curtis
Additional Authors and Speakers: Lisa Leppla
Contributing Authors: Sarah Dietrich, Grace Hovde, Muhammad Al-Heizan, Kristen Pickett
PURPOSE: Evidence suggests that deaf and hard-of-hearing (DHH) individuals are more dependent on others to complete instrumental activities of daily living (IADLs) than their age-matched hearing counterparts (Werngren-Eleström et al., 2005). However, data to support these claims are limited. Additionally, interventions focused on task and physical performance specifically adapted to address the needs of the DHH community are lacking. The purpose of this pilot study was to investigate performance on an IADL kitchen task among DHH individuals compared with healthy age-matched peers and to quantify the effect of an 8-wk adapted yoga program on IADL performance measured using the Performance Assessment of Self-Care Skills (PASS; Rogers et al., 2016).
METHOD: A cross-sectional, quasi-experimental design was used to compare DHH individuals at baseline to a healthy age-matched population. A within-subject, pretest–posttest quasi-experimental design was used to examine the effects of the 8-wk yoga class. Ten participants were recruited from the Office of the Deaf and Hard of Hearing, and the Aging and Disability Resource Center of Dane County sponsored the yoga program. Inclusion criteria included self-identification as DHH, normal vision, ability to walk independently for at least 10 min, age 18–80, ability to attend the yoga class for 8 wk, Mini-Mental Status Exam score of >24, and ability to provide informed consent. Exclusion criteria included contraindication for yoga participation or exercise, schedule conflict during more than 2 wk of the yoga sessions, and involvement in another research study or intervention focused on balance.
IADL performance was measured using Sections 24–26 (kitchen and cooking tasks) of the PASS at baseline and after completion of the 8-wk yoga class. The PASS was administered according to specified criteria (Rogers et al., 2016). Participants were given a set of directions and moved through four kitchen tasks: (1) making instant muffins following package instructions, (2) making soup following package instructions, (3) peeling and cutting an apple into eight slices, and (4) washing used dishes. The yoga class was designed to focus on balance and falls prevention addressing the needs of the DHH community. All classes were taught with an American Sign Language (ASL) interpreter and a communication access real-time translation (CART) interpreter present in a room equipped with a hearing loop system. Pretest and posttest data were analyzed using paired-sample t tests.
RESULTS: Data from eight DHH individuals were analyzed. PASS scores improved from baseline to posttest (p = .02). These results are preliminary in nature. Blind scoring of the PASS data is being completed from video recordings of all trials to remove any possible rater bias. It should be noted that some learning may have occurred from the baseline measurement to posttest.
CONCLUSION: Although limited by the sample size, the baseline to posttest data show the possible benefits to IADL performance of a yoga intervention that has been adapted to fit the needs of DHH individuals. Additionally, this pilot study provides quantitative data describing the functional limitations of DHH individuals in the performance of IADL tasks. Activity modification is highlighted throughout the Occupational Therapy Practice Framework: Domain and Process (American Occupational Therapy Association, 2014), and occupational therapy practitioners possess the necessary skill set to adapt physical fitness programs to meet the needs of the DHH community. This study provides information for practitioners as they continue to meet the unique needs of this population.
References
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1–S48. https://doi.org/10.5014/ajot.2014.682006
Rogers, J. C., Holm, M. B., & Chisholm, D. (2016). Performance Assessment of Self-Care Skills test manual (Version 4.1). Pittsburgh, PA: Author.
Werngren-Eleström, M., Iwarsson, S., Elmståhl, S., & Dehlin, O. (2005). ADL dependence and perceived health among elderly deaf sign-language users: A comparison with a matched group of elderly hearing people. Scandinavian Journal of Occupational Therapy, 12, 81–88. https://doi.org/10.1080/11038120510031743
