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ORTHOPAEDIC AND POSTURAL DEFECTS. Some children with the more severe degrees of
these defects were referred, as in previous years, to the orthopaedic surgeon at the Children's
Hospital, Plaistow, and various other special hospitals. In many cases insoles or wedging of
the shoes were prescribed, while in a few cases minor orthopaedic operations were carried out.
Cases are referred from time to time to the Council's physiotherapy clinic by hospitals in
order to save the parents' time, but the specialists usually request to see the cases
occasionally. Following the establishment of the Council's own physiotherapy service at the
beginning of 1952, 114 children were treated at Forest Street and Grange Road clinics and at
the Elizabeth Fry special school during the year. Cases known to have been treated outside
the Council's scheme numbered 192. Eleven children were known to be in-patients in various
hospitals. In accordance with the National Health Service arrangements surgical boots and
orthopaedic appliances are provided by the hospitals when needed.
PHYSIOTHERAPY. Mrs.A.M.Tootell, the physiotherapist, continued her work on a parttime
basis. She attends three full days a week, approximately half of the time being devoted
to the School Health Service. Two clinics are held weekly at the Forest Street Child Welfare
Clinic and two weekly at Grange Road Child Welfare Clinic: at each of these clinics both
school children and pre-school children are treated. In addition the physiotherapist attends
one day a week at the Elizabeth Fry day special school. Visits are paid to the Fyfield Open
Air School from time to time. Children are usually referred to the physiotherapist by the
school medical officers, the consultant paediatrician, general practitioners and hospitals.
Much time is taken up with classes of children requiring remedial exercises for bad
posture, flat feet, weak ankles, knock knees and other minor orthopaedic defects. Massage,
as well as ultra-violet irradiation, is given when necessary. The results achieved have been
very satisfactory, particularly in the classes for foot defects, and this gives support to
the view that these conditions, if treated early enough, can be more easily remedied and
probably spared the need for later treatment at an orthopaedic clinic. Many cases are given
general ultra-violet irradiation, mostly cases of asthma, bronchial or upper respiratory
catarrh, or general debility. The type of mercury vapour lamp employed enables several
children to be treated simultaneously in a group. Breathing exercises are also given,
especially in certain chest conditions. These facilities, provided on premises which are
easily accessible and well known to the parents and children, encourage acceptance of
treatment at a stage when it will be really preventive.
The physiotherapist carries out valuable work at the Elizabeth Fry day special school
where various deformities - the aftermath of anterior poliomyelitis, cerebral palsy and
hemiplegias are dealt with. By paying weekly visits to the school the physiotherapist becomes
familiar with the defects of the individual child. Some of these children receive ultraviolet
irradiation at the nearby Grange Road Clinic. In the same way much good is done by
the visits to the Fyfield Open Air School for delicate children where those with asthma,
bronchitis, upper respiratory catarrh, poor posture and general lack of tone are given
treatment. In these cases the physiotherapist also gives guidance to the nursing staff so
that they can continue the relatively simple treatment in between her visits. The nursing
staff carry out this treatment in a most satisfactory way.
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