Frenkel’s Exercise

BIPUL DEBNATH
(PHYSIO.BIPUL93BD@GMAIL.COM)
&
KULSUM AKTER
B.SC IN PHYSIOTHERAPY

BANGLADESH HEALTH PROFESSION INSTITUTE (CRP)

 CONTENTS:

• Introduction
• Definition
• Indication
• Aim
• Technique
• Factors affecting exercises
• Principles
• Exercise in different postures
• Progression
 INTRODUCTION

• Heinrich Sebastian Frenkel.

• Swiss physician.
• An early practitioner of neuro-rehabilitation.
• Developed in 1889 to treat patients of tabes dorsalis and
problems of sensory ataxia owing to loss of proprioception.
 DEFINITION
It is defined as the series of gradual progressive exercises designed
to increase coordination.
 AIM

1) To establish control of movement,

2) Able to confident in his ability to carry out those activities
which are essential for independent activities of daily living.
 INDICATION
• Cerebellar ataxia
• Tabes Dorsalis
• Stroke
• Multiple sclerosis
• Wilson’s disease
• Cerebral palsy
• Parkinson’s disease
• Others neurologic disorders
 FACTORS AFFECTING THE EXERCISES

• Deformity
• Mal posture
• Pain
• Asymmetry
• Mental and psychological stress
• Overweight
 THE MAIN PRINCIPLES

• Concentration or attention
• Precision
• 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
FRENKEL’S EXERCISES FOR LOWER LIMBS
IN LYING

a)Lying(Head raised): Hip abduction & adduction

b)Lying(Head raised): Hip flexion
c)Lying(Head raised): Heel shin coordination
d)Lying(Head raised): Bicycling position
 STARTING POSITION
Lying on a bed or with a smooth surface along which the feet
maybe moved easily.
 A)LYING(HEAD RAISED): HIP ABDUCTION

Floor contact abduction 4 inch above from floor

 CONTINUE….

4 inch above floor with sand bag

 A)LYING(HEAD RAISED): HIP ADDUCTION

Floor contact adduction 4 inch above from floor

 CONTINUE …

4 inch above floor with sand bag

 B)LYING(HEAD RAISED): HIP FLEXION

Bend one leg at the hip and

knee sliding heel along the
bed. Straighten the hip and
knee to return to the starting
position. Repeat with the
other leg.
C)LYING(HEAD RAISED):HEEL SHIN COORDINATION

Starting position Ending position

 D)LYING(HEAD RAISED): BICYCLING POSITION

Bend one leg at the hip and knee while straightening the other in a
bicycling motion.
FRENKEL’S EXERCISES FOR LOWER LIMBS
IN SITTING

a)Sitting: Place a position indicated by a mark on the floor.

b)Sitting: Sit to stand.
 STARTING POSITION:

Sit on a chair with feet flat on the floor.

A)SITTING: PLACE A POSITION INDICATED
BY A MARK ON THE FLOOR.

Place the foot print from starting position

B) SITTING: SIT TO STAND.
 EXERCISE FOR THE LOWER LIMBS IN
STANDING

a)Stride standing: transference of weight from Foot to Foot.

b)Standing: walking placing Feet on marks.
c)Stride standing: walking small and wide placing Feet on marks
on the floor.
d)Standing: turn around.
 EXERCISES WHILE STANDING:

Starting position: Stand erect with feet 4 to 6 inches apart.

 A)STRIDE STANDING: TRANSFERENCE OF
WEIGHT FROM FOOT TO FOOT.

Right side weight bearing Left side weight bearing

 B)STANDING: WALKING PLACING FEET ON
MARKS.

Walk forward placing each foot on a footprint traced on the floor.

Footprints should be parallel and 2 inches from a center line.
C)STRIDE STANDING: WALKING SMALL AND WIDE
PLACING FEET ON MARKS ON THE FLOOR.

Small base Large base

D)STANDING: TURN AROUND.
 UPPER EXTREMITY EXERCISES

• Eye-hand coordination
• Finger-nose coordination
• Try to reach an object
• Picking up objects
EYE-HAND COORDINATION
FINGER-NOSE COORDINATION
TRY TO REACH AN OBJECT
PICKING UP OBJECTS
PRACTICAL SESSION
 BENEFITS OF FRENKEL’S EXCERCISE

• Improve co-ordination.
• Improve balance.
• Improve body awareness.
• Improve postural awareness.
• Improve selective movements.
• In some cases, improve proprioception.
 PROGRESSION OF FRENKEL’S EXERCISES

• Made alteration in speed, range & complexity

• Quick movements, less control
• Slow movement, high control
• According to disability re-education starts from lying to standing.
 REFERENCES
• Physical rehabilitation assessment
and treatment-susan B.O’
Sullivan, Thomas J. Schimitz.
• http//:en.wikipedia.org
• The principal of exercise therapy
M Dina Gardiner.
• Text book of rehabilitation
• Internet (google scholar.yahoo etc)
• Image from http//:www.google.com,bd
Any Question?
THANK YOU
FOR YOUR
PATIENCE!