Child with disability having musculoskeletal therapy in swimming pool (Shutterstock 1541055515)
Researchers from Plymouth Institute of Education and the Faculty of Health collaborated with children with neurodisabilities to explore their perceptions of activities and exercises that help promote their chest health. Katherine Gulliver and Rachel Knight Lozano designed a research study to encourage children with a range of disabilities to share their ideas and experiences of activities at school.
Four children aged between 5-16 years used action cameras and audio recorders to record their experiences and thoughts. The children took researchers on a tour of their school, and showed the different activities and exercises they use. Teachers, teaching assistants and the parents and carers of children also took part in interviews to highlight the perceived benefits and challenges to activities.

What is chest health?

Chest health refers to the management of a person's chest, lungs and breathing.
Chest health is particularly important for people who are at risk of respiratory illness such as chest infections.
Chest physiotherapy can help clear excess mucus and help you breathe more freely.
Exercise and physical activity is important for children and young people with disabilities, to help improve motor skills, balance and coordination, and mental health. 
Children with a neurodisability who are at risk of respiratory illness require access to a range of activities and exercises to help promote general health and wellbeing.

Benefits

Children and staff highlighted the benefits of accessing the hydrotherapy pool for children to be able to move through the water, stretch, relax and have fun with their peers. Similarly, rebound therapy was highlighted as a sociable and fun activity for children to enjoy. 
One participant shared:
“I really like being on the floor, because I spend all the time in my chair” and “I like swimming at school with my friends”.  
Other activities included using a walking frame, standing frame and exploring the floor, playing with toys or interacting with their friends. By using the different equipment, children were able to increase their independence and self-esteem.
Child with disability has musculoskeletal therapy by doing exercises in body fixing belts (Shutterstock 522295510)
Child with cerebral palsy has musculoskeletal therapy by doing exercises in body fixing. (shutterstock 1381952171)

Challenges 

Children shared their frustrations with being unable to access forest school areas due to uneven, muddy terrain. Similarly, children experienced difficulty navigating narrow doorways or relying on others to open the doors which prevented their independence. Often, a number of school staff were needed to assist children in safely moving from their chair to the floor, pool or trampoline using a hoist. 
Discussions with key stakeholder groups highlighted a range of different activities and access issues depending on the opportunities available to them. Generally, children's opportunities to play with friends and develop their confidence, wellbeing and independence were more talked about than chest health. It was clear that using different activities and exercises were helpful for children's general health and wellbeing, but chest health in particular was less known about.    

Next steps

The research project was extended through funding from the University's Explore Award which enabled researchers to collaborate with external partners such as representatives from Active Devon, Stuart Heron Headteacher of Mayfield School, and Plymouth Parent Carer Voice Forum. The partnerships enabled the research to be shared with stakeholders from a range of health and educational professions across Devon and Plymouth, and parents/carers of children and young people with disabilities. Discussions of the next steps of the project include how to share the findings in an inclusive, educational resource for children, families and professionals to help promote exercise and activities for chest health. 

Research staff

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