Frenkels exercises for coordination an overview:
Frenkels exercises for coordination were first introduced by Dr.H.S.Frenkel was a neuro physician from Switzerland. He developed these exercises for the treatment of an ataxic patient suffering from tabes dorsalis. Tabes dorsalis is a neurological disorder where the dorsal root ganglia of the spinal cord are damaged which results in loss of sensation for proprioceptors.
As result coordination is lost. Coordination means smooth, accurate, and purposeful movement without any jerk. Frenkel performed his exercises in a precise and repeated manner for arms and legs in lying, sitting, standing, and walking. After successful treatment of an ataxic patient now frenkel’s exercises are used for many other conditions where coordination is a problem.
What is coordination?
When we talk about coordinated movement then we can say coordinated movements are those movements that are organized, performed accurately, and smoothly without any disturbance.
Our body’s natural movements are coordinated. There are many diseases where coordination is lost and patients are unable to perform daily activities adequately. Uncoordinated movements are jerky and rough.
Tests to check coordination:
Coordination is tested during neurological examination. The examination room should be large and well lighted so that all the movements are easily accommodated. A watch is also available to note the time while starting and ending the test. The patient should be in a comfortable position and give a brief demonstration of the tests to the patient. There are the following tests for coordination.
- Finger to nose test
- Finger to therapist's finger
- Heel on shin
- Drawing a circle
- Romberg test
In which disease Frenkels exercises for coordination are used?
There are many neurological disorders where Frenkels exercises for coordination are used such as:
Multiple sclerosis:
Multiple sclerosis is an autoimmune disorder where immune cells become active against the myelin sheath which is a protective covering around the neurons. Damage to this myelin sheath results in pain abnormal sensations in the arms. Damage to the cerebellum also occurs in multiple sclerosis which results in ataxia(incoordination) and balance problems. The cerebellum is a part of the brain which is responsible for accurate movements when this part is damaged it results in poor movement patterns and loss of coordination. so all the features resulting from cerebellar damage like unstable walking(ataxia), loss of balance and coordination can be improved by using frenkel’s exercises.
Cerebellar ataxia:
Frenkel’s exercises are used to treat cerebellar ataxia which indicates ataxia due to cerebellar dysfunction. As the cerebellum is responsible for synchronized and coordinated movements of muscles so lesions in the cerebellum result in gait abnormalities, inability to maintain rhythm(dysdiadochokinesia), and inability to control movement range(dysmetria). Slurred speech and nystagmus and tremors are also result from cerebellar ataxia.
Parkinson’s disease :
Frenkels exercises for coordination are also used in Parkinson's disease which is a progressive neurological disorder with motor and nonmotor symptoms. Frenkel’s exercises are used to treat motor symptoms of Parkinson, mainly the tremors and postural instability.
Frenkels exercises for coordination of lower limb:
Frenkels exercises for legs can be done in four different positions: lying, sitting, standing, and walking.
Exercise for lower limb in lying:
- The patient is lying supine on the exercise mat, bed, or at a treatment table with a fully relaxed position.
- Raised the head by placing a pillow under the head.
- Now slowly bend the hip and knee to the full range of motion while your foot touches the surface.
- Bring back and straighten the leg so that leg should be in full extension at the hip and knee joint.
- The next exercise is to move your leg away from your body toward the corner of the bed and bring it back to the medial side. This type of exercise is called abduction and adduction at the hip joint.
- Place the heel of one foot on your shinbone and bring it toward your knee and then move it back toward the ankle.
- Now bend the knee and hip simultaneously and move it outward and then bring back inward and then straighten your leg.
- Repeat all the exercises as much as possible but start with low repetitions to avoid fatigue.
- Count movements at leg or play suitable music during frenkel’s exercise.
Frenkel’s exercises for lower limb in sitting:
- Position yourself on a chair in a comfortable manner.
- Now straighten the right leg by sliding the heel on the floor and bring it to the specific mark on the floor and then move back in the same pattern.
- Stretch the left leg and place the heel on the mark by lifting it.
- Repeat this exercise until it becomes easy.
- Now move to the next exercise, try to stand putting weight on your heels, and then sit again.
- Change the position from sitting to standing while grasping an object like wall bars.
Exercises for lower limb in standing:
- Transfer weight on one-sided leg and then shift it to the second leg in a standing position.
- Turn yourself in a circle by placing feet on a specified mark on the floor
Exercises for lower limb in walking:
- Walk from side to side while placing feet on marks on the floor.
- Place different things on the floor and then walk and change your direction to cross hurdles.
Frenkel's exercises for coordination of upper limb:
We can perform frenkel's exercises for arms in different postures as we have done for legs such as:
Sitting:
- Have the patient sit on a chair, stretch the arm and touch a specified mark or to the therapist's hand and then bring it back to the chair arm.
- Move the arm in a circle.
- Position the patient in a comfortable sitting on a chair in front of a table, place small objects on the table, and then ask to pick these objects from their position one by one and drop them to another place.
- While sitting, place hands on your thighs and then quickly supinate and pronate the forearm.
Standing :
- While standing, move your arm back and forth like a pendulum.
- In standing position throw a ball and then bounce to catch a ball.
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