Evaluating the impact of school-based rebound therapy on chest health in children and young people with neurodisability and respiratory issues: a series of single case studies.

Abstract

To evaluate feasibility and impact of an individualised rebound therapy programme on chest health in children with complex neurodisability. A single-case ABA design was conducted over 18 weeks with five children aged 5-15 years with complex neurodisability. Intervention involved twice weekly rebound therapy for six consecutive weeks in school. Summary outcomes included parent/carer-reported chest health, quality-of-life and clinician-observed motor ability. Serial weekly outcomes included chest health observations, usual care changes, adherence and adverse events. Parents completed a semi-structured interview after follow-up. Quantitative data were analysed descriptively and qualitative data were analysed using thematic analysis. Within-case and across-case findings indicated improvement in motor ability following rebound therapy intervention. Additional trends of improvement were noted in parent/carer-reported chest health and quality-of-life, but these changes were not specific to the intervention phase. Improvements in motor ability, chest health and quality-of-life indicators were verified through qualitative interview data. Co-design successfully informed an inclusive, feasible intervention study for children with complex neurodisability. However, overall improvement in parent/carer-reported chest health, quality-of-life and observed motor ability were not limited to the intervention phase. Measurement tools lacked published thresholds to determine if changes were clinically significant.