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164
Annual Report of the London County Council, 1913.
exemplified fully but improvement was observed in these after the class had been held for some months.
Seven visits were paid to the class, two visits being devoted to a physical examination of the
children. Note was made as to the reason why they were included in the class and a measurement made
of the chest and of the respiratory excursion. The other inspections were of the children actually
doing their exercises. The effect of the exercises on various conditions are as follows:—
Average increases—height, 2.7 c.m.; chest measurement at rest, 0.85 c.m.; excursion (least to
greatest) 0.3 c.m.
Kypho-lordosis 5 Improved. 4 Slightly improved. 2 Unaltered.
Lateral curvature 1 „ 1 „ 2 „
Mouth breathing and
enlarged tonsils 2 „ 3 „ 5 „
Further points such as quickening in response, improvement in carriage, the manner in which
the exercises were carried out, and improvement in general appearance were noticed, but, presumably
owing to the bad conditions under which the children live, the results were not well marked.
From observations made of the class under working conditions some improvements can be
suggested to increase efficiency. Cases should be selected from higher departments where defects are
commoner. The number in class should be limited to, say, twelve. It is found difficult to ensure
correct form if the class is large. Practically individual attention is necessary. The class should always
be in open air when weather is dry. It is advisable, but doubtfully practicable, that a tunic should
be worn and that abdominal exercises, involving lying on the ground, should be included.
Chaucer, Bermondsey (Girls)—(Dr. Boome).—This class was held from 5th May, 1913, to
12th December, 1913. The children were chosen from 60 others. They were originally selected by the
head teacher because they had been recommended for treatment at previous medical inspections.
Finally 20 children were picked out on account of round shoulders and faulty posture habits. On close
medical examination 2 children were exempted as suffering from doubtful early phthisis, and were
replaced by two others.
The class was held every day for 20 minutes either in the hall of the school, or when the weather
permitted on the roof playground, and the routine consisted of handkerchief drill, breathing exercises,
physical exercises, simple dancing (country dances and dance steps). Breathing exercises were given after
the handkerchief drill and during the class. The teacher was careful not to give breathing exercises after
the more vigorous exercises, but first gave simpler exercises, e.g., "heel raising," thus allowing the heart
to settle down.
The physical exercises were carefully selected beginning with the simpler and ending at the latter
part of the term with the more difficult exercises as laid down in the syllabus of Physical Exercises
(Board of Education), Tables 1-15 then 37-48 and 66 (kneeling). Every endeavour was made by the
teacher in charge of the class to get the children to enjoy the exercises, rather than look on them as a task.
At the outset of the class the teacher in charge was present during the medical examination of each child.
Whilst the child was being examined faulty positions and postural defects, if any, were pointed out to
the teacher. As the children were stripped to the waist, it was easy to emphasise the faults and point out
the remedy. After the medical examination the children, still stripped to the waist, were put through
the following simple movements: (i.) Fundamental standing position; (ii.) Wing or "hips firm";
(iii.) Rest; (iv.) Stretch; (v.) Trunk bend; (vi.) Kneel. The common faults noted were in
(i.) Protruding abdomen. Curved back; (ii.) Elbows too far back; (iii.) Head too far forward;
(iv.) Arms forward; (v.) Knees bent. Rigid spine; (vi.) Bad balance. Rigidity. The postural defects
found in the class were:—
Kyphosis (round shoulders) 6, very slight; 3, slight.
Scoliosis 6, slight curves to left; 4, slight curves to right.
Lordosis 4, „ „ —
It is interesting to note that in the class were 3 cases of uneven vision (not corrected) associated
with slight lateral curves, 2 to the left and one to the right. The vision noted in each case was
respectively 18-24, 18-12 and 18-12. There was marked improvement in these cases at the end of the
class. The postural defects noted above were decreased and in 4 cases disappeared entirely.
It was noticeable that the deportment of the children was improved and in several cases became
graceful. The sacro-spinal group of muscles was developed, and the scapulo-spinal group showed marked
improvement. In the fundamental standing position, where at first protrusion of the abdomen occurred,
there was great improvement owing to the strengthening of the abdominal muscles. Shortened pectoral
muscles were stretched by the exercises and the set of the shoulders and chest development consequently
improved, in a number of cases. Rigidity of the chest wall and trunk moreover disappeared with
the regular exercise.
It will be seen from the tables that there was a decrease as a rule in the pulse rate, the regular
exercises having a beneficial effect on the heart. Anaemia was benefited, so that the nutrition of the heart
muscle was improved. The teacher was particularly instructed to see that the breath was not held during
the exercises. There was a great tendency for the children to do this at first, especially those who were
overkeen. This fault was commented on a year or so ago in the army, where the drill instruction
was given by non-commissioned officers not under medical supervision. This accounted for a good
number of dilated hearts with consequent invaliding from the service. Towards the end of the class, it
was seen that the children did the exercises smartly with the least amount of effort. In no case was there
the slightest dilation of the heart, as shown by the displacement of the apex beat from the mid clavicular
line. There were 5 cases of bronchial catarrh noted at the first medical examination; these all cleared up.