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

Purpose
To evaluate feasibility and impact of an individualised rebound therapy programme on chest health in children with complex neurodisability.

Methods and materials
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.

Results
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.

Conclusion
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.