# A self-made suspension trainer as a tool for core muscle activation and motivation in a girl with cognitive and motor impairments: a case report

## TL;DR

A homemade suspension trainer helped a girl with cognitive and motor impairments improve core muscle activation and therapy engagement.

## Contribution

A low-cost, therapist-made suspension trainer was used to improve engagement and task performance in a child with complex neurodevelopmental needs.

## Key findings

- The suspension trainer led to increased repetitions and reduced need for assistance during therapy sessions.
- The child showed improved engagement and task performance with the new training approach.
- Qualitative observations suggest potential benefits for children with neurodevelopmental impairments.

## Abstract

Children with combined cognitive and motor impairments often experience persistent difficulties with postural control, core muscle function, and motivation for rehabilitation. Low-cost, engaging approaches may be particularly relevant in resource-limited settings.

This case report describes a 13-year-old girl with a history of perinatal hypoxic-ischemic brain injury and early-onset seizures, who had severe cognitive and motor impairment. Caregiver-provided clinical documentation indicated severe intellectual disability (ICD-10: F72.0) and degree II–III activity limitations (as graded within national rehabilitation documentation) across domains including self-care, mobility, communication, behavioral regulation, and learning-related functioning. Clinically, she demonstrated marked core and scapular weakness, a rounded upper back posture, and reduced motivation after years of conventional therapy.

A self-made suspension trainer was constructed from accessible materials (rope, gym stick, and floor mat) and integrated into therapy sessions. The main task consisted of supported sit-ups combined with assisted pulling, enabling partial weight support, with gradual progression in repetitions and independence.

Across sessions, observable changes were noted in task performance and engagement, including increased repetitions and reduced need for assistance. Outcomes were documented through session logs, therapist observation, and caregiver report; no standardized outcome measures were applied.

This single-case report provides qualitative, hypothesis-generating observations suggesting that a low-cost, therapist-made suspension trainer may support engagement and task performance in a child with complex neurodevelopmental needs. These findings are not generalizable and warrant evaluation using standardized outcomes and longer follow-up.