FRENKLE’S EXERCISES

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 FRENKEL’S
EXERCISES:
 Frenkel’s exercises was presented by
DR HS Frenkel .He was a physician
from Switzerland .
 He made the special study on Tabes
dorsalis and derived the procedure for
treating sensory ataxia.
FRENKEL’S EXERCISES are a series of exercises of
increasing difficulty program by ataxic patients to
facilitate the restoration of coordination.’’

Q: what is ataxia?
 ATAXIA:
Ataxia describes as lack of muscle control or action
of voluntary movements due to tabes dorsalis
,damage of cerebellum ,multiple sclerosis , usage of
alcohol and multiple sclerosis.
 HISTORY:
One day when Frenkel examining the patient of ataxia ,
observed patient’s poor performance of finger to nose test and he
didn’t passmonths
 Several the test later
. , on re-
examination patient showed
extraordinary improvement in co-
ordination.
 Frenkel was astonished and asked the
patient what happened in interval
,patient replied ,
“I Wanted to pass the test and so I
practiced.”
 This event inspired Frenkel to a general
assumption: If one patient can reduce
 He immediately started to study in practical manner.
his ataxia by practice ,why not all?
 PRINCIPLES
Concentration: The concentration may create the
proprioceptor activities over the joint. The visual
watching the movement are recorded in brain and it may
improve the kinesthetic sense.
Precision : Movements should be accurate and
rhythmical. Movement which the patient performs will be
recorded in his brain through the visual pathways.
Speed and range : Quick movements needs less
control than slow movements. The speed should maintain
slow. Therapist directs speed through command, using
hand counting no. etc.
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Command : audition is another source for sensory
mechanism to compensate the proprioceptive activities
and involuntary movements.
Repetition : The repetition of the accurate
movement improves the kinesthetic sense and the
coordination . Repeating the movements are helpful for
the cerebrum to record and memorize one particular
movement perfectly.
complication : complexity introducing in the
exercise regimen, improves the coordination as well as
proprioceptive activities. It may increase the
concentration power and memorizing capacity of the
brain on particular movement. 6
 GENERAL INSTRUCTIONS FOR
FRENKLE’S EXERCISES:
Exercises are designed primarily for
coordination not for strengthening
 Commands should be given in an event ,slow voice;
the exercise should be done to counting.
 It is important that area is well lit and that patients
are positioned so every movement easily watch by
patients .
 Exercise should be done within normal range of
motion to avoid overstretching of muscles .
 The first simple exercises should be adequately
performed before progressing to more difficult
 Four basic patterns are used:
lying, sitting , standing and walking.
 Simple and single movements are retrained first ,
followed by alternative movements of contralateral
limbs then more complex pattern.
 The counting tempo must be the patients own
 Use of any part of sensory mechanism which
remained intact such as vision , hearing and touch , to
compensate for loss of kinesthetic sensation and
ataxia .
 Avoid fatigue, each exercise not more than 4 times,
rest should be there between exercises.
 Patient should be guarded against fall.
 Frenkel
Exercises for
upper limb
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 In lying position
 Patient in lying position, ask him to move his
arm away from the body and then towards the
body to the marked point.(abduction and
adduction)
 Patient in side lying, flexion and extension of
shoulder
 Patient in side lying, flexion and extension of
elbow.
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 In sitting position
 Have patient sit in front of a table and place a number of
objects on the table. The patient then touches each object with
the right hand and then the left hand.
 The patient flexes the right shoulder to 90 degree with elbow
and wrist extended. The patient then takes his or her right
index finger and touches the tip of his or her nose.
 The patient taps bilateral hands on bilateral thighs while
alternating palmer and dorsal surfaces as fast as possible.
 Transferring the ball from one hand to another hand.
 Reaching the therapist finger which is in air.
Certain diversional activities such as building with toy bricks or
drawing on a black board, buttoning, combing, writing, typing
are some of the activities that also improves the coordination.
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