In response to the question "What are you having difficulty with?" most often older adults respond by describing a functional activity, for example climbing stairs, getting into and out of the bathtub, or picking an item up from the floor. Sometimes they respond with a complaint about a physical parameter. They may say, for example, that they feel their legs are weak or tired; or that they are experiencing joint, muscle, or regional pain; or that they feel stiff. Most likely with further questioning older adults can link their physical discomfort with a functional activity. For example, they experience back pain when they walk, or they feel so stiff that they cannot put their socks on. The functional activity of interest and the physical parameters required to complete that activity can then be used to guide and direct the development of an individualized, client-centered exercise program.
The trend toward including and practicing functional activities in an exercise program for older adults is evident from the information in Canada’s Physical Activity Guide to Healthy Active Living for Older Adults, the NIH Exercise for Older Adults, and the Senior Fitness Test. From a client-centered and goal-driven approach to exercise prescription for older adults, inclusion of functional activities in an exercise program seems appropriate. Further, the inclusion of functional activities in an exercise program addresses the principle of specificity, according to which exercise targeting a specific activity promotes improvement in the performance of that activity. Measurement of performance of the specific functional activity or a highly related activity will inform the exercise leader and the participant of the gains that have been made with the exercise program to reach the target goal.