Proximal Stability


Proximal stability is the ability to hold the trunk and the joints around the trunk (i.e. hips, shoulders, elbows etc.) in a constant position while forces such as gravity act upon them in either direction. It requires normal muscle tone and the ability to coordinate opposing muscle groups around a joint. This is an important pre-requisite skill for good fine motor ability as it provides the background stability for refined hand use.

Home and Inside activities

  • Activities with large arm movements: E.g. twirling a jump rope, a ribbon on a stick, sparklers or dancing.

  • Wall press-ups: Standing at an arm’s length distance from the wall, place hands flat against the wall at shoulder level, the elbows should be straight at this stage. Do press-ups by leaning into the wall, bending the elbows and keeping the feet in one spot. Then push back away from the wall by straightening the elbows. Repeat this several times. Once the child can do this easily, try starting with feet placed further away from the wall.

  • Box ride: Let one child sit in a box (e.g. big plastic crate with wheels or big apple box from the fruit &veggie store) while the other child pushes or pulls the friend/sibling around in the house. When doing this on tiles/wooden floors/laminated floor boards it will be easier (less resistance) than on carpet, grass or outside on the pavement.

Art Time

  • Drawing or painting on a vertical surface: Use an easel or a large piece of paper stuck onto a wall, window, white board or mirror.

  • Drawing on a chalkboard or on the mirror: Start by encouraging large movements, e.g. draw a simple maze for the child to follow or a large picture to colour in. You can do a big “lazy 8” with a paintbrush, finger paint or large crayons. Encourage smaller movements as ability improves.

  • Use window chalk or soap crayons and allow your child to draw pictures on windows or large sliding/glass doors.

Outside Activities

  • Wheelbarrow walking:
    Practice walking on hands with an adult or another child supporting at the hips. Children must walk on their hands not their elbows. You can incorporate this activity into a game by having races with other children or by having the child retrieve objects scattered around the room while walking as a wheelbarrow.
  • Wheelbarrow walk challenge:
    Once your child gets better at the wheelbarrow walking and is able to do so without support at the hips or trunk, you can upgrade the challenge. Place various objects on the floor and let them walk over it. E.g. wheelbarrow walk over scatter cushions on the floor (various textures and heights), over bubble wrap placed on the floor, across a matrass or when you are at the park on a low balance beam or tires. You could also let your child do wheelbarrow walking backwards. It is a great challenge.
  • Animal walks:
    Have the child pretend to walk like different types of animals, such as:
    • Frog Jumps: Your child should sit on their haunches with their hands on the floor in front of them, then jump in to the air like a ‘frog’, and land in the same position. Make sure they land back on their feet, not their knees.
    • Rabbit Jumps: Your child should sit on their haunches with their hands in front of them. To jump like a rabbit, they should move their hands forwards first, then ‘hop’ their legs forwards, returning to the original position.
    • Seal walks: Your child needs to lie on their stomach, propping themselves up on extended arms. Then using only their arms (no legs) they should drag themselves across the floor. A slippery floor or mat works best for this activity.
    • Crab walks: Let your child sit on their buttocks and put their hands behind them, with their fingers pointing backwards, then lift their pelvis up off the floor. They should then walk around the room like this making sure they keep his pelvis off the floor. You can ask them to collect an item from the other side of the room like this, by putting it on their stomach while walking.
    • Donkey kicks: They should kneel on all fours/in the crawling position, and then kick in the air while leaning forward on their hands.
  • Tug-of-war games:
    Use an old sheet or blanket or a thick piece of rope. This can be played with an adult or another child, where one opponent tries to pull the other over a line drawn on the floor.
  • Pushing, pulling and carrying heavy objects:
    E.g. helping carrying the shopping, helping move furniture for vacuuming, or holding the dog’s leash when going for a walk (depending on the size of the dog!). Ensure weight is relative to the child’s size and strength.

Please be advised that the activities suggested within this website are selected to develop and improve specific areas of developmental difficulty. Engaging in these activities only, cannot replace the valuable input and guidance an Occupational Therapist (OT) can provide you with.

In order to benefit optimally from these activities, it is best advised to do these activities with the guidance of your OT. Many parents and caregivers benefit from attending an activity demonstration consultation. Although the activities selected are games that children often play at home or at school, and are generally safe to engage in, the Therapists at this practice cannot be held liable for any injuries occurring while playing any of these games.

Children learn through Play and having fun!! Research has proven that children who have fun are more motivated to learn and have better retention of the learnt skill! Enjoy playing and learning with your child!

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