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2. FRENKLE’S EXERCISES
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DPT-1st year
JPMC

3. 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?

4. 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.

5. HISTORY:
 Several months 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 his
ataxia by practice ,why not all?
One day when Frenkel examining the patient of ataxia , observed
patient’s poor performance of finger to nose test and he didn’t pass the test .
 He immediately started to study in practical manner.

6. 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. 6

7. 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.
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8. GENERAL INSTRUCTIONS FOR
FRENKLE’S EXERCISES:
 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 patterns.
Exercises are designed primarily for coordination
not for strengthening

9.  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 patient’s 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.

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Frenkel's
Exercises for upper limb

11. 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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12. 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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Frenkel's
Exercises for lower limb

14. 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. 14

15. 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).
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16. In Sitting
One leg is stretched to slide the heel to a position
indicated by a mark on the floor.
The alternate leg is lifted to place the heel on the
marked point.
Rise and sit with knees together.
Sitting hip abduction and adduction.
Sitting knee flexion and extension
Unsupported foot and touching the therapist’s finger,
which is in air.
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17. In Standing
In stride standing weight is transferred from 1 foot to
other.
Place foot forward and backward on a
straight line.
Walk sideways by placing feet on the
marked point.
Walk and change direction to avoid
obstacles.
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