Rebound Therapy

REBOUND THERAPY

“ Rebound Therapy is a fun, enjoyable and achievable activity that is accessible to all”

INTRODUCTION 

The term ‘rebound therapy’ coined by the physiotherapist, remedial gymnast, and headteacher Eddy G Anderson in 1969. It is a therapeutic use of a trampoline to develop and promote motor skills, promote an increase or decrease muscle tone, body awareness, balance, coordination, and communication, promote relaxation as well as improve fitness and exercise capacity. It is a therapeutic intervention aimed at populations with special needs and can benefit a wide range of individuals including those with physical disabilities, learning difficulties, sensory impairments, and those on the autistic spectrum.

It is a highly enjoyable activity and is used to great effect as a cross-curricular teaching tool.

BENEFITS OF REBOUND THERAPY

1.  PHYSIOLOGICAL 
2.  THERAPEUTIC
3.  SENSORY INPUT
4.  INTERPERSONAL

PHYSIOLOGICAL EFFECTS

 1. Motor development -Stimulating the vestibular system helps to keep the brain alert and ready to take on new information.

2. Cardio-respiratory   -A high demand for the muscle to deal with the effect of gravity on deceleration and acceleration, causing an increase in the respiratory and heart rate. The constant muscle work required to maintain position and balance increases the demand for Oxygen.

3. Stamina - Increase due to controlled jumping and regular sessions.

4. Muscle tone/ tension - low-level bouncing can cause a decrease in muscle tone and vice versa with high-level bouncing.

5. Postural mechanism -Stimulating the sensory system through joints, muscles, and skin can improve the output to the important postural muscles.

6. Balance mechanism -The dynamic movement achieved through the right challenges balance mechanisms and observable improvement can be achieved.

7. Stimulation of the digestive system - Improved bowel function and organ massage- achieved by the rhythmic movement of the trampoline.

8. Clearing of toxins from the body - Bouncing causes the stretching and contracting of cells in the body.

THERAPEUTIC EFFECTS

 1. Relaxation – by using good positioning and low amplitude bouncing, good relaxation is easily obtained

2. Sense of calm - the rhythmical motion develops a body map and a sense of calm through consistent and predictable sensory feedback.

 

SENSORY INPUT

1. Proprioceptive feedback – the stronger proprioceptive (joint) feedback provided when bouncing on the trampoline overrides tactile sensitivities in clients that are tactile defensive.

2. Kinaesthetic awareness - by the multiple stimulations of joints, pressure stretch receptors, skin, and muscles, kinaesthetic awareness is improved, leading to improved body image and spatial awareness.

3. Spatial awareness - locating the center of the trampoline, spinning/ twisting movements, and awareness of the position of the body and limbs throughout the phases of light.

 4. Height and depth perception – controlled high and low jumping, mounting, and dismounting the trampoline.

INTERPERSONAL 

1. Body awareness – the use of proprioceptive, tactile, and vestibular input to promote body awareness and body image.

2. Patience/ social awareness – participants are required to wait for their turn and move through the progressions of the rebound therapy program.

3. Trust and co-operation

4. Independence and self-confidence – progression to bouncing or jumping on their own, mounting or dismounting unaided. Completion of activities within the program.

5. Self-image – peer approval, achievement through the development scheme, coach praise, and feeling good having worked hard.

6. Communication – due to cardio-respiratory effects, vocalization is increased with exclamations and gasps.

7. Eye-contact and concentration 

CONTRAINDICATIONS

Cardiac or circulatory problems

Down's syndrome

Respiratory problems

Vertigo

Blackouts or nausea

Epilepsy

Spinal cord or neck problems

Spinal nodding

Open wounds

Osteogenic Imperfecta (Brittle bone disease)

Unstable / hypermobile / painful joints

Hernia

Implant surgery (e.g., Baclofen pump in CP)

Prolapse

Stress incontinence

Joint replacement

ABSOLUTE CONTRAINDICATIONS

Pregnancy - The trampoline during pregnancy can cause disruptions to the womb and has the potential to cause harm to an unborn baby. Also, the extra strain of such a high energy sport may cause damage to the mother whose vital organs are already functioning at a higher than normal level.

Detaching retina - when retina starts separate from the eye socket. It causes blindness if not treated early. 

Atlantoaxial instability – associated with 10-40% of people with down’s syndrome (Trisomy 21). Weakened ligaments are normal in Down’s syndrome, causing slack joints. This may cause a weakness in the atlantoaxial joint of the first (atlas) and second (axis) vertebrae, right below the skull & these vertebrae which can lead to brain damage and paralysis. This makes sufferers of atlantoaxial instability prone to slippage of vertebrae

People who have spinal rods

People with Achondroplasia or another skeletal dysplasia - People with Achondroplasia and some other forms of dwarfism have an exaggerated lumbar lordosis and spinal stenosis, these 2 factors increase the jarring forces through the spine on impact.

WINSTRADA TRAMPOLINE PROGRAMME 

The program is made up of 10 grades with each grade having a no. of sections. Each section within a grade focuses on different movements or aspect of trampolining.

Grade 1,2 and 3 of the program have been adapted to match the exercises that form the basis of rebound therapy.

Grade 1 focuses on foundational abilities and for the child to gain confidence with the trampoline.

Grade 2 looks at progressive movement patterns and a higher level of spatial awareness.

Grade 3 through to grade 10 focus on trampoline form and specific movements and routines.

 

EXAMPLE OF TRAMPOLINING PROGRAMME

Grade 1- Section A

1. Lies or sits on a soft object (Beanbag)

2. Enjoys being bounce while lying or sitting on a beanbag

3. Enjoys movement with the parachute

4. Enjoys rocking motion of bed when lying down

5. Being bounced in back lying position –maintains shape

 

Grade 2- Section B

6. Can achieve two-footed jump – landing evenly

7. Can achieve two-footed jumps repeatedly- landing evenly

8. Perform 3 bounces – stop – stillness

9. Standing position – bounces with quarter twists

10. Pogo – moving around the trampoline, understands and performs forwards backward and sideways movements.

11. Haka (fast knees up together and touch)

HUDDERSFIELD FUNCTIONAL INDEX (HFI) 

It is an outcome measure that measures progress in rebound therapy. 

INTERPRETATION 

In the HFI, each movement, of the Winstrada trampoline program, is scored on a scale from 0-4. A score of 0 means they are unable to complete it and 4 means they can complete it competently and independently.

 

CONDITIONS THAT CAN BE TREATED BY REBOUND THERAPY

1. Hypertonia

2. Hypotonia

3. Profound and multiple learning disabilities (PMLD)- These groups of individuals with severe learning disabilities as well as other disabilities, such as difficulties with movement, communication, vision, hearing, etc. They are often wheelchair-bound and have complex health issues.

4. Autistic spectrum disorders (ASD) – they improve focus and concentration and improve the ability to maintain eye contact as a child with an ASD will need to focus and pay attention to the instructions provided by the therapist.