These movement activities require a special approach regarding the attitude towards people with PIMD, because of their limitations in cognitive-and motor functioning (Nakken & Vlaskamp, 2007). People with PIMD are fully wheelchair dependent or require personal assistance to mobilize and change body position (Nakken & Vlaskamp, 2007). Technical devices and extensive support are needed to accommodate people with PIMD and supporting even very small movements of the limbs and postural changes of people with PIMD. In current practice, demanding activities, such as bouncing on a bouncy castle (Van der Putten, Houwen, & Vlaskamp, 2014), activities in a swimming pool (e.g. Watsu: Dull, 2004), and power-assisted exercises using machines that assist people with PIMD to passively move their arms and legs are used (Bossink, Van der Putten, Waninge, & Vlaskamp, 2017). In addition, small-scale activities are integrated in the daily support, such as activation to lift of an arm, standing using a standing tool and assist to turn over during dress