Frenkel Exercises Handout
Frenkel Exercise Manual Pdf

frenkel’s exercises
It is defined as the series of gradual progressive exercises designed to increase coordination.
Method of treating the ataxia & incoordination.
Mechanism is based on voluntary control of movement by use of sensory mechanism i.e sight, sound & touch to compensate for the loss of kinesthetic sensation.
Essentials are

Concentration of attention
Precision

TCC is strongly recommended as a regimen of coordination exercise to prevent the elderly from falling.' A study involving stroke patients and the effectiveness of Frenkels exercises found significant gains in relation to coordination, balance and functional activities with the inclusion of Frenkel exercises in physical therapy approach.

Frenkel Exercises are a series of motions of increasing difficulty 30+ Hand Therapy Exercises after Stroke Evidence Based Therapeutic (PDF Download Available) Effectiveness of physiotherapy for (PDF Download Available).
Frenkel Exercises were originally developed in 1889 to treat patients of tabes dorsalis and problems of sensory ataxia owing to loss of proprioception. These exercises have been applied in the treatment of individuals with ataxia, in particular cerebellar ataxia. The exercises are performed in supine, sitting, standing and walking.
Frenkel Exercises are a series of motions of increasing difficulty performed by ataxic patients to facilitate the restoration of coordination. Frenkel's exercises are used to bring back the rhythmic, smooth and coordinated movements. 285 People Used.
Coordination exercise-. General instructions to coordination exercise. Techniques of coordination exercise. Upper and low.

III. Repetition
TECHNIQUE of frenkel’s exercises
Position & clothing
Explanation of exercise
Attention of patient
Speed of movement
ROM by marking spots
Repetition of exercises
Rest periods
PROGRESSION of frenkel’s exercises
Made alteration in speed, range & complexity
Quick movements, less control
Slow movement, high control
Simple movements build up to form complex movements e.g walking
According to disability re-education starts from lying to standing.
frenkel’s exercises For The Legs In Lying
a)Lying(Head raised); Hip abduction& adduction
b)Lying(Head raised);one Hip & knee flexion & Extension
c)Lying(Head raised); one Leg raising to place Heel on specific mark
d)Lying(Head raised); Hip & Knee flexion & extension, abduction & adduction
frenkel’s exercises For The Legs In Sitting
a)Sitting;one Leg stretchin,to side heel to a position indicated by a mark on the floor.
b)Sitting; alternate Leg stretching & lifting to place Heel or Toe on specified mark.
c)Stride sitting; change to standing and then sit down again.
Exercise For The Legs In Standing
a)Stride standing; transference of weight from Foot to Foot.
b)Stride standing; walking sideways placing Feet on marks on the floor.
c)Standing;walking placing Feet on marks.
d)Standing; turn around.
e)Standing; walking and changing direction to avoid obstacles.
Exercises For The Arms
a)Sitting (one Arm supported on a table or in slings); Shoulder flexion or extension to place Hand on a specified mark.
b)Sitting; one Arm stretching, to thread it through a small loop or ring.
c)Sitting; picking up objects and putting them down on specified marks.
EXERCISES TO PROMOTE MOVEMENT AND RHYTHEM
All exercises are repeated to rhythmic count.
a)Sitting; one Hip flexion & adduction.
b)Half lying; one Leg abduction to bring knee to side of plinth, followed by one Knee bending to put Foot on floor, the movement is then reversed & repeated.
c)Sitting; lean forward and take weight on Feet(as if to stand), then sit down again.
d)Standing; Arms swing forwards & backwards(with partner holding two sticks).
e)Standing or walking; bounce & catch, or throw & catch a ball.
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Frenkel Exercises are a series of motions of increasing difficulty performed by ataxic patients to facilitate the restoration of coordination. Frenkel’s exercises are used to bring back the rhythmic, smooth and coordinated movements.Dr. H S Frenkel was a physician from Switzerland who aimed at establishing voluntary control of movement by the use of any part of the sensory mechanism which remained intact, notably sight, sound and touch, to compensate for the loss of kinaesthetic sensation. Frenkel Exercises were originally developed in 1889 to treat patients of tabesdorsalis and problems of sensory ataxia owing to loss of proprioception. These exercises have been applied in the treatment of individuals with ataxia, in particular cerebellar ataxia. The exercises are performed in supine, sitting, standing and walking. Each activity is performed slowly with the patient using vision to carefully guide correct movement. These exercises require a high degree of mental concentration and effort. Patients with partial sensation can progress to practicing exercises with eyes closed. The main principles of Frenkel exercises are the following: Concentration or attention , Precision , Repetition . This program consists of a planned series of exercises designed to help patient compensate for the inability to tell where the arms and legs are- in space without looking.

• Exercises are designed primarily for coordination; they are not intended for strengthening.
• Commands should be given in an event, slow voice; the exercises should be done to counting.
• It is important that the area is well lit and that patients are positioned so that they can watch the movement of their legs.
• Avoid fatigue. Perform each exercise not more than four times. Rest between each exercise.
• Exercises should be done within normal range of motion to avoid over-stretching of muscles.
• The ﬁrst simple exercises should be adequately performed before progressing to more difﬁcult patterns.

General Instructions for frenkel exercises

• Exercises can be performed with the part supported or unsupported, unilaterally or bilaterally.
• They should be practiced as smooth, timed movements, performed at a slow, even tempo by counting out loud.
• Consistency of performance is stressed and a specified target can be used to determine range.
• Four basic positions are used: lying, sitting, standing and walking.
• The exercises progress from postures of greatest stability (lying, sitting) to postures of greatest challenge (standing, walking).
• As voluntary control improves, the exercises progress to stopping and starting on command, increasing the range and performing the same exercises with eyes closed.

Frenkel exercises for lower limb
Exercises for the legs in lying

• Flex and extend one leg by the heel sliding down a straight line on the table.
• Abduct and adduct hip smoothly with knee bent and heel on the table.
• Abduct and adduct leg with knee and hip extended by sliding the whole leg on the table.
• Flex and extend hip and knee with heel off the table.
• Flex and extend both the legs together with the heel sliding on the table.
• Flex one leg while extending the other.
• Flex and extend one leg while taking the other leg into abduction and adduction.
• Heel of one limb to opposite leg (toes, ankle, shin, patella).
• Heel of one limb to opposite knee, sliding down crest of tibia to ankle.

Whether the patient slides the heels or lifts it off the bed he has to touch it to the marks indicated by the patient on the plinth. The patient may also be told to place the heel of one leg on various points of the opposite leg under the guidan

Frenkel Exercise Manual