Frenkels exercise

physiotherapy exercise to improve coordination

1. FRENKEL EXERCISES Frenkel Exercises are a series of motions of increasing difficulty performed by ataxic patients to facilitate the restoration of rhythmic, smooth and coordinated movements.

2. INTRODUCTION 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 tabes dorsalis and problems of sensory ataxia owing to loss of proprioception.

3. TECHNIQUE TECHNIQUE The patient is positioned & suitably clothed so that he can see the the limbs throughout the exercise Concise explanation & demonstration of exercise Patient must give attention to perform exercise Speed of exercise is dictated by therapist by means of rhythmic counting ROM indicated by marking spot on which foot (or) hand placed Exercise is repeated till its perfect & easy Frequent rest periods must be allowed

4. The main principles of Frenkel exercises are the following Concentration or attention Precision Repetition

5. TECHNIQUE of Frenkel’s exercises TECHNIQUE The patient is positioned & suitably clothed so that he can see the the limbs throughout the exercise Concise explanation & demonstration of exercise Patient must give attention to perform exercise Speed of exercise is dictated by therapist by means of rhythmic counting ROM indicated by marking spot on which foot (or) hand placed Exercise is repeated till its perfect & easy Frequent rest periods must be allowed

6. — Frankel’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 the specific mark d)Lying(Head raised); Hip & Knee flexion & extension, abduction & adduction

7. Hip range of motion

8. Knee range of motion

9. Combination of hip and knee

10. Anatomical land mark

11. Frankel’s exercises For The Legs In Sitting — a)Sitting; one Leg stretching, 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.

12. —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.

13. Side walking

14. Turning towards left

15. Turning towards right

16. — 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

17. — EXERCISES TO PROMOTE MOVEMENT AND RHYTHM — 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.

18. 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.

19. BENEFITS OF FRENKEL’S EXCERCISE • Improve co-ordination. • Improve balance . • Improve body awareness. • Improve postural awareness. • Improve selective movements. • Improve proprioception.

20. THANK YOU