Proximal Stability

Dr Laura Mraz and Proximal Stability

What is it? Strength and stability of the muscles closest to the center of the body (Case-Smith & O’Brien, 2015). 

Why is it important? Having proximal stability, such as adequate core or shoulder strength, provides the body parts further away from the core with better mobility and stability. So, if a child has a strong core, their shoulders, arms, wrists, and hands would have more support, stability, and mobility as well, therefore increasing function in fine motor activities. Proximal stability is necessary for occupations throughout the lifetime, such as: 

  • Activities of daily life (dressing, feeding, bathing, grooming, functional mobility, toileting) 
  • Academic performance (writing, fine motor activities, cutting) 
  • Play and leisure activities (puzzles, sports, etc.) 
  • Job performance 
  • Home management (cleaning, organizing, laundry, etc.) 
  • Meal preparation 
  • Driving 
  • Care of others 

5 activities to try at home: 

Dr Laura Mraz and Proximal Stability

1. Wheelbarrow walking. 

Tip: Weightbearing exercises are great for proximal stability. You can also try animal walks; such as bear walks or crab walks! 

Dr Laura Mraz and Proximal Stability

2. Drawing on window, wall, or easel.  

Tip: Writing or drawing on vertical surfaces is a great way to engage core and shoulder muscles. 

Dr Laura Mraz and Proximal Stability

3. Putting a puzzle together while tummy on ball. 

Tip: Try having your child prop themselves up while their body is on a ball in order to complete a puzzle or play with a preferred toy. If you do not have a big ball, try having the child prop themselves off the couch! 

Dr Laura Mraz and Proximal Stability

4. Playing on playground. 

Tip: Swinging across monkey bars or climbing up equipment is a great way to strengthen shoulders! 

Dr Laura Mraz and Proximal Stability

5. Scooter boarding while on tummy along a path! 

Tip: Prone extension activities are great for proximal stability. Try using a skateboard if you do not have a scooter board! Try pulling child with a rope if propelling themselves is too challenging at first. 


American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1-S48. 

Case-Smith, J., & O’Brien, J. (2015). Occupational therapy for children and adolescents (7th ed.). St. Louis, MO:  

Elsevier Mosby, Inc.