Assessment of gait can also provide valuable information. Measuring stride length and width, in addition to observing the overall pattern, can help in determining whether there is a diminished capacity to support the entire body. Poor posture, torso sway, shuffling of the feet, and overall apprehension by the individual can all be related to weakness in muscle tissue.
Exercises specific to the development of gait stability focus primarily on the pelvic area. Closed-chain movements such as step-ups, squats and lunges, with proper progression, are the most specific to "real Life" function. Equipment such as the multi-hip machine is very beneficial for strengthening adductors, abductors, flexors and extensors. Although this machine is intended to isolate certain muscles, there is actually a two-fold benefit. While the active leg is performing work, the opposite leg must also work isometrically to facilitate the exercise.
Exercises that offer additional stabilization include a variety of agility patterns and trunk development methods. Toe walking (actually walking on the balls of the feet with heels raised), heel walking, cross-over forward patterning, and the grapevine maneuver, as well as torso work with stretch bands, tubing and large rubber balls, all stimulate neural recruitment that will help develop stabilization.
Remember that the older adult population varies tremendously with respect to individual differences and capabilities. Therefore, the exercise specialist must consider the appropriateness of each activity. However, regardless of the current functional level of the individual, a prudent exercise prescription can always be established and, likewise, "real life" function can always be enhanced.