London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1912

[Report of the Medical Officer of Health for London County Council]

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144
Annual Report of the London County Council, 1912.

80 cases; round shoulders, 33 cases; defective breathing, 51 cases, though in none could the breathing have been described as good. The following table shows the results noted on re-examination at the end of the course.

Defect.Much improved.Improved.Little change.Worse.Total.
Lateral curvature of spine4107122
Ant.post. curvature of spine15331058
Round shoulders211233
Weak breathing30192-51

The case of lateral curvature which deteriorated had ceased to receive exercises in the special
class, and was in July receiving special remedial exercises at a hospital, but it seemed not improbable
that eventually other measures would be required.
Effect of
Instruction
The effect of the instruction was most marked on the general posture and carriage of the children,
and particularly on the power of executing complete stretching movements of the trunk and limbs.
Many exercises quite unsuited for performance at the commencement were easily undertaken at the
end of the course, while many children who had been unable to benefit from the ordinary class
exercises had caught up to the normal standard and even surpassed it.

The numbers and changes recorded in posture, carriage, and stretching movements were as follows:

Condition.General posture and carriage.Power of executing full stretches.
Much improved4143
Improved6765
Little change1617
Worse1

The children recorded as showing little change were, for the most part, those who had carried
themselves best originally and had the least leeway to make up. Very definite advances were recorded
in the chest expansion of the children in the special class; they gained on an average 16 mm. (⅔ inch)
in the six months, whereas the average change during that period for children of a corresponding class
varied from 2 to 4 mm. (1/12 to 1/6 inch). Although this gain is not so much one of growth as of the utilisation
of powers of movement previously in a dormant condition, the actual growth somewhat exceeded
that of the normal children, the average increase in the circumference of the fully expanded chest being
15 mm. instead of 12 mm.
The improvement in the condition of the skin previously referred to was commented upon by
several teachers. Since this was the case in those who had not received school meals or milk, as well as in
those in receipt of this additional aid to health, the change may be credited in part, at least, to the exercises.
At the end of the period the children were brighter, in a better state of health, and able to undergo
much more exertion without getting out of breath. They consequently were in a better condition to
Undertake their ordinary class work.
During the progress of the experiment the medical staff of a hospital adjacent to one of
the schools requested that certain of their patients should be allowed to join the special class
for daily exercise.
The exercises employed were all taken from the syllabus issued by the Board of Education, though
the selection, and to some extent the interpretation varied from school to school, and in consequence
perhaps, the extent of the maximum improvement manifested was not always the same. It is
interesting to note that the greatest improvement in the breathing capacity occurred in those instances
in which the attention had been most evenly spread over all varieties of exercise and in which the
teachers had had the most experience prior to the commencement of the special classes. This lends
support to the view that the best method of improving the general breathing powers is to take complete
courses of movements at each lesson rather than to concentrate attention on special movements to the
exclusion of others of a more general character.
The teachers took the greatest interest in these classes and stated that they had derived much benefit
from being shown the exact movements performed by each child while it was stripped for the purpose
of the preliminary and final medical examinations. Their admission to these examinations and
demonstrations does something to put them in the position of those drill mistresses at secondary schools
who attend the medical examinations to receive special advice on the defects of individual pupils. It
would be useful for the teachers to receive a little instruction in the principles involved in the exercises
demonstrated by or on a few children, some able and some unable to carry out the movements correctly.
The most suitable age period would be 8 to 10, as in these children the onset of faults might be prevented
and the more weakly brought to a stage at which they could profit by the ordinary class instruction
rather than to attempt the far more difficult task of remedying the perhaps long standing
defects in the older children. The results of the experiment are such as to warrant its extension, and
arrangements have been made for the classes to be held during the present year in connection with 27
schools—an increase of 19.