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Physiotherapy: Adults and Paediatrics:

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and Cardiac Problems 5th Edition
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1
 Dysfunctional Breathing

References

6 Outcome Measurement in Cardiorespiratory Physiotherapy

Practice
Introduction

International Classification of Functioning Framework

Selection of an Outcome Measure

Measurement of Impairment at Body Structure/Functions Level

Measurement of Activity Limitations

Measurement of Participation Restriction

References

7 Physiotherapy Interventions
Traditional and Manual Airway Clearance Techniques

Independently Performed Airway Clearance Techniques

Exercise and Pulmonary Rehabilitation for Airway Clearance

Adjunctive Techniques

Intermittent Positive Pressure Breathing

Non-Invasive Ventilation

Incentive Spirometry

Manual and Ventilator Hyperinflation

Glossopharyngeal Breathing

Positioning and Mobilization

Oxygen Therapy

Hypertonic Saline

8
 Mannitol

Dornase Alpha

Bronchodilators

Structuring an Airway Clearance Session

Differences between Shortness of Breath and Dyspnoea

Mechanisms Underpinning Dyspnoea

Assessment of Dyspnoea

Management Strategies for Dyspnoea

Inspiratory Muscle Training

Breathing Control

Manual Therapy Techniques for Musculoskeletal Dysfunction

Neurophysiological Facilitation of Respiration

References

8 Optimizing Engagement and Adherence with Therapeutic

Interventions
Introduction

Impact of Diagnosis

Living with Cardiorespiratory Illness

Engagement with Medical Teams

Conclusion

References

9 Adult Intensive Care

Introduction

Monitoring and Mechanical Support

9
 Problem Identification and Physiotherapeutic Interventions in ICU

Physiotherapy Management of Work of Breathing and Concepts of

Weaning from Mechanical Ventilation

Conclusion

References

10 Paediatric Intensive Care

Introduction

Epidemiology of Acute Respiratory Failure in Children

Indications for Supportive Respiratory Therapy

Mechanical Ventilation

Newer Ventilatory Support Techniques

Ventilation Strategies for Specific Disease

Other Considerations During Mechanical Ventilation

Level of Perinatal Care

Reasons for Admission to NICU

Congenital Diaphragmatic Hernia

Oesophageal Atresia and Tracheo-Oesophageal Fistula

Gastroschisis and Exomphalos (Omphalocoele)

Pulmonary Conditions

Treatments Available for Respiratory Conditions in the NICU

General Paediatric Intensive Care

Common Reasons for PICU Admission

Paediatric Cardiac Intensive Care

References

10
11 Upper Abdominal and Cardiothoracic Surgery for Adults
Introduction

Preoperative Physiotherapy and Prehabilitation

The Surgical Process

Types of Surgery

Special Considerations Following Surgery

Acknowledgements

Appendix

References

12 Physical Activity and Rehabilitation

Physical Activity Versus Physical Fitness

Physical Activity, Physical Fitness and Health

Strategies to Improve and Maintain Physical Fitness

Introduction

Aims of Rehabilitation in Chronic Obstructive Pulmonary Disease

Exercise Prescription

The Training Programme

Education and Self-Efficacy

Timing of Rehabilitation

Non-COPD Populations

Practical Aspects of Training

Long-Term Effects of Pulmonary Rehabilitation – Is Benefit

Maintained?

Conclusions

11
 Introduction

Cardiac Rehabilitation – Past, Present and Future Directions

Benefits of Exercise Training

Recommended Levels of Physical Activity and Exercise

Exercise Prescription

Programme Implementation

Conclusion

References

13 Cardiorespiratory Management of Special Populations

Introduction

Introduction

Introduction

Introduction

Acute Spinal Cord Injury and Respiration

Respiratory Assessment

Physiotherapy Treatment

Long-Term Respiratory Management

Conclusion

Introduction

History

Selection of Candidates

Indications for Transplantation

Contraindications to Transplantation

Assessment

12
Surgical Procedures

Key Concepts

Preoperative Rehabilitation

Postoperative Management

Outpatient Rehabilitation

Exercise Limitation and Function Post Transplant

Long-Term Management

Specific Considerations for Paediatric Patients

Conclusion

Acknowledgement

Introduction

Causes and Mechanisms of Injury

Complications Related to Traumatic Injury

Medical and Surgical Management of Patients with Traumatic Injury

Physiotherapy Intervention for the Trauma Patient

Quality of Life after Traumatic Injury

Conclusion

Introduction

Rehabilitation in Special Paediatric Populations

Cystic Fibrosis

Asthma

Other Respiratory Conditions

Obesity

Heart Disease

Exercise Prescription

13
 Introduction

Physical Activity for Cancer Prevention

Medical Treatment of Cancer and the Associated Side Effects

Lack of Physical Activity after a Diagnosis of Cancer

Physical Activity Guidelines for People Living with Cancer

The Role of Exercise Training in the Management of Cancer

Delivery and Timing of Exercise Training for Individuals with Cancer

Evaluation of Exercise Training for Individuals with Cancer

Exercise Prescription for Individuals with Cancer

Monitoring during Exercise for Individuals with Cancer

Strategies for Adherence to Increased Physical Activity for Individuals

with Cancer

Definition and Mechanisms of Muscle Weakness in ICU

Patients Who Are Unconscious/Sedated

Conscious and Stable Patients

Neurocognitive Interventions

Resources

Summary

References

Appendix Normal Values, Conversion Table and Abbreviations

Normal Values

Conversion Table

Abbreviations

Index

14
Copyright

© 2016 Elsevier Ltd. All rights reserved.

Previous editions:
© 1993 Longman Group (UK) Limited.
© 1998, 2002, 2008 Elsevier Ltd. All rights reserved.

No part of this publication may be reproduced or transmitted in

any form or by any means, electronic or mechanical, including
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www.elsevier.com/permissions.
This book and the individual contributions contained in it are
protected under copyright by the Publisher (other than as may be
noted herein).

ISBN 978-0-7020-4731-2

Notices
Knowledge and best practice in this field are constantly changing.
As new research and experience broaden our understanding,
changes in research methods, professional practices, or medical
treatment may become necessary.

15
Practitioners and researchers must always rely on their own
experience and knowledge in evaluating and using any
information, methods, compounds, or experiments described
herein. In using such information or methods they should be
mindful of their own safety and the safety of others, including
parties for whom they have a professional responsibility.

With respect to any drug or pharmaceutical products identified,

readers are advised to check the most current information provided
(i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or
formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on
their own experience and knowledge of their patients, to make
diagnoses, to determine dosages and the best treatment for each
individual patient, and to take all appropriate safety precautions.

To the fullest extent of the law, neither the Publisher nor the
authors, contributors, or editors, assume any liability for any injury
and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of
any methods, products, instructions, or ideas contained in the
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For Elsevier
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16
Printed in Italy

17
Dedication

To Barbara, Jennifer and Ammani

18
Foreword
As previous editors of this textbook we feel very fortunate to have
two remarkably busy professors of physiotherapy who have carried
forward the editorship of this book. They are both actively involved
in leading cardiorespiratory physiotherapy research and in teaching
under- and postgraduate physiotherapists – Eleanor Main in
London and Linda Denehy in Melbourne.
The editors have brought together a wealth of knowledge and
evidence-based practice in respiratory and cardiac medicine,
physiotherapy and assessment techniques. Expert clinicians have
contributed important new material in cardiorespiratory care. This
international collaboration will facilitate further progress for the
benefit of both physiotherapists and patients.
Despite improvements in the design, quality and rigour of allied
healthcare research, there remains a paucity of evidence and a lack
of clarity for best practice in some clinical areas. In physiotherapy
research the ‘gold-standard’ randomized controlled trial is often
fraught with difficulty because of the inability to conceal treatment
allocation from participants. This can create uncontrollable bias
resulting from patient preference, particularly in studies which
involve a long-term burdensome intervention. Therefore clinical
expertise currently remains an important element of evidence-
based practice.
There have been many changes in healthcare provision and we
have come a long way since the early days of ‘chest physiotherapy’
and ‘postural drainage’ prescribed by medical practitioners. This
edition recognizes physiotherapists as highly skilled indepen​dent
practitioners who are integral members of the multidisciplinary

19
team. Their considerable depth of knowledge and ability to
interpret the many and ever-increasing investigative tests enable
them to identify appropriate treatments, exercise or education
programmes which meet the needs of individual patients.
This comprehensive new edition will be a great asset to both
undergraduate and postgraduate physio​therapists and other health
professionals interested in respiratory and cardiac problems. The
increase in research and improvements in clinical practice,
undertaken during the 23-year lifetime of this textbook, are in part
due to imaginative methods, advances in technology and education
by enthusiastic clinicians and academics such as our two new
editors. We believe that this edition will inspire another generation
of physiotherapists to advance our profession.
Barbara A Webber
Jennifer A Pryor
S Ammani Prasad

2016

20
About the Editors

Eleanor Main

Eleanor Main has been involved with clinical physiotherapy,

teaching and research at Great Ormond Street Hospital for Children
and the Institute of Child Health at University College London for
almost 24 years. She qualified as a physiotherapist at the University
of the Witwatersrand, South Africa (1988) and worked as a
paediatric physiotherapist at both the Red Cross Children's
Hospital in Cape Town and then Great Ormond Street Hospital in
London. She completed a BA (English and Psychology) at UNISA in
South Africa (1991), an MSc in research methods from King's
College, London (1995) and a PhD in paediatric respiratory
physiology from University College London (2001).
She was appointed as Lecturer in Children's Physiotherapy

21
Research at UCL in 2001, promoted to Senior Lecturer in 2007 and
to Professor of Physiotherapy in 2015. She has been programme
director for the UCL postgraduate Certificate, Diploma and MSc in
physiotherapy at UCL since 2005 and has supervised five PhD
students and 79 MSc project dissertations to date. In 2011 she was
awarded a Fellowship of the Chartered Society of Physiotherapy in
London for her ‘significant contribution to education, teaching and
learning in the field of cardiorespiratory and paediatric
physiotherapy’. Eleanor's primary research interests relate to
outcome measurement and clinical efficacy studies in
physiotherapy. This research, resulting in more than 80 peer-
reviewed publications, and attracting over £2.8 million in project
grant funding so far, has resulted in substantive advances in the
understanding of assessment and treatment of children who require
physiotherapy.

Linda Denehy

Linda Denehy is a PhD-qualified physiotherapist who is Head of

the Department of Physiotherapy at the University of Melbourne,
Australia. Linda graduated in physiotherapy in Melbourne and
spent 20 years as a clinician managing respiratory medicine,
thoracic surgery and ICU patients both in Melbourne and at the
Brompton Hospital in London. She has been a teaching and
research academic for nearly 20 years and obtained her PhD in 2002
in the management of patients having upper abdominal surgery.

22
Linda developed curricula in cardiorespiratory physiotherapy both
for undergraduate and for postgraduate students and led the
implementation of the new three-year doctor of physiotherapy
entry to practice course at the University of Melbourne. She has
supervised 30 higher degree research students to completion and
has extensive research expertise in the area of cardiorespiratory
physiotherapy, particularly in patient populations who are acutely
unwell, including patients after major surgery and critically ill
patients. She has published more than 100 research publications in
peer-reviewed journals and 15 invited editorials or book chapters
and has been invited to more than 25 national and international
meetings as a keynote speaker. These include the European
Respiratory Society in 2014 and the American Thoracic Society in
2014 and 2016. She is currently involved in developing international
guidelines for ICU mobility and outcome measures in ICU. Linda
has been successful in obtaining funding from more than 30
applications of over $6 million Australian dollars for research into
physiotherapy and rehabilitation, including as a chief investigator
on five nationally competitive grants in rehabilitation after critical
illness, lung cancer and breathlessness in COPD. She reviews for
national and international competitive granting bodies and for
several international scientific journals including Lung Cancer,
Intensive Care Medicine, Critical Care Medicine and Thorax. Her
research has contributed to evidence-led practice, clinical guidelines
and improved patient-centred outcomes.

23
Preface
It has been a real privilege to be invited to co-edit the fifth edition of
this core international cardiorespiratory textbook. It has always
been an important text for undergraduate students around the
world but is also an enduringly valuable reference text for both
experienced and novice practitioners involved with
cardiorespiratory care.
There have been some interesting and important advances in
cardiorespiratory physiotherapy in the nine years since the first
printing of the fourth edition, and we have tried hard to include as
many of the new ideas and new pieces of evidence as possible.
Having said that, we acknowledge without reserve that we ‘stand
on the shoulders of giants’, and many of the essential timeless
features of the earlier editions remain intact.
Before we started, we asked clinical and university staff and
students what they most wanted to see in this new edition and, as a
result, we have made changes that we think will enhance the book.
Some of the changes involved updating information or
reorganizing where it is found in the text, and some are entirely
new chapters. For example, the new first chapter is an overview of
cardiorespiratory anatomy and physiology essentials, with
wonderful new illustrations, which we hope will be an outstanding
clinical reference. Similarly, the assessment chapter, now doubled
in length, provides an expanded and structured systematic
approach to clinical cardiorespiratory assessment. Other new
chapters include two dedicated to cardiac and respiratory problems
or pathology, an outcome measures chapter, a chapter on the
principles of exercise and physical activity in cardiorespiratory

24
populations and a chapter on cardiorespiratory rehabilitation of
special populations, for example, children or those with obesity,
cancer, liver disease or burns. Also new is the structure of the
Physiotherapy Interventions chapter (previously Techniques),
which is now problem-based rather than alphabetical, and which
hopefully will facilitate a clearer clinical reasoning pathway for
students or novice practitioners.
In general, topics related to the care of children with
cardiorespiratory problems have now been incorporated into
appropriate sections of text throughout the book, either because
there is significant overlap in approach or care between adults and
children, or because understanding children with cardiorespiratory
problems facilitates better care of individuals through the lifespan:
problems in childhood frequently continue into adulthood. An
exception is the division between the adult and paediatric ICU
chapters, because differences in the reasons for hospital admission
and clinical and physiotherapy management of these populations
remain substantial.
We are excited about and proud of the new edition and hope that
it continues to serve physiotherapy professionals in
cardiorespiratory care around the world for many years to come.
EM
LD
London and Melbourne 2016

25
Another random document with
no related content on Scribd:
 THE STRAIN THAT MAKES THE CORNING EGG FARM FAMOUS

As The Corning Egg Farm was located within a few miles of New
York City the breeds which laid the white shelled egg were the only
ones worthy of consideration, and, in the study of the question, it
was found there was another important matter confronting the egg
farmer, as to the breed which he should keep, whether a setter, or a
non-setter. On an egg farm, where hundreds of layers are to be kept,
if any of the Asiatics, or so called American Breeds, were kept, they
would be a source of considerable added expense, first, in the way
of loss of eggs during their numerous broody periods; second, in the
necessary buildings in which to carry the “broody biddies” until they
have become sensible, and are in a proper frame of mind to be
returned to the Laying House. This might look on its face a small
affair, but success to The Corning Egg Farm has come through
watching every corner, and while sparing no needed expenditure,
avoiding unnecessary and foolish outlay.
So, to the man who would really meet with a large success, all the
breeds which lay the dark shelled egg, because of their setting
propensity, must be eliminated.
 All the members of the Mediterranean family are layers of the
white shelled egg, and are what is termed “non-setting.”

S. C. White Leghorns Outclass All

Before deciding we looked the different members of this family
over with considerable care, and we found that the Single Comb
White Leghorn is the fowl that out-classes all the others for the
purpose of an egg farm. It is a bird, where properly bred, of great
hardiness and stamina. It readily adapts itself to all conditions of
climate, and, where the right “strain” is procured, it is never a
disappointer as to the number, size, and the class of eggs which it
produces. We, therefore, decided to adopt the Single Comb White
Leghorn, and we have outlined, in a previous chapter, how we went
to work to build up the unequaled Corning Strain, by the most careful
selection, and scientific mating.
Prof. Gowell, at the Maine Agricultural Station, carried on his
breeding with Barred Plymouth Rocks, and it is interesting to note
that his average for some eight years, taking his star performers,
was 134.27 eggs per hen for twelve months, while at The Corning
Egg Farm the flocks of fifteen hundred pullets averaged per hen, for
ten months laying, 143.25 eggs in 1909, and 145.11 eggs in 1910.
Here was a difference of two months in time, and yet the large
flocks, taken as a whole, not weeding out a few star performers,
surpassed the twelve months’ record of the Barred Plymouth Rocks
at the Maine Station by almost nine eggs in 1909, and ten eggs in
1910. This significant fact made considerable impression on a
number of breeders in the neighborhood of Boston, with the result
that, in the last two years, The Corning Egg Farm has supplied a
large number of hatching eggs and considerable breeding stock for
farms in New England.
As one gentleman from Boston pointed out, even with the
difference in price between the brown and the white egg, he found
that he could not really afford to continue with the breeds laying the
brown egg, for the Leghorn, in numbers, more than made up for the
slight difference in price between the two colors, in the Boston
Market. And, as he still further pointed out, it took less food to supply
the Leghorn than it did any of the larger breeds, and this, of course,
was another source of economy.
It should be remembered that the “Strain” of any breed is most
important. One may purchase White Leghorns where the inbreeding
has been so great that they are not capable of laying eggs in large
numbers, and the percentage of fertility from the hatching standpoint
in such birds will be a most uncertain quantity. Such chicks as may
be hatched will be far from strong, and the mortality will run into
figures which will dishearten anyone.

Line Breeding—Not Inbreeding

In the building up of a great strain of birds it is necessary to “line
breed,” for, if the old theory of introducing new blood to prevent
inbreeding, and the method of introducing the new blood, was, as is
done in so many places even to-day, by introducing males from other
sources, the entire system falls down. Nothing is accomplished and
time is worse than wasted. The possibility of handing down the
virtues of mother to daughter, and of father to son, is eliminated. If all
the qualities of a given “Strain” are to be handed down line breeding
must be adhered to in the strictest sense. Inbreeding, however, must
be avoided, or disaster will follow.

How Corning Farm Produces Unrelated Cockerels

The Method of The Corning Egg Farm is as follows: a pen of
carefully selected yearling hens is set aside in what is known as “the
pen for the production of unrelated cockerels.” A most carefully
selected cockerel to every twelve hens is placed in the pen.
Incubators are run with eggs from this pen only, and the resulting
chicks are marked before being placed in the Brooder House. The
cockerels which appear with this marking are grown to maturity,
those coming up to our standard being selected to head the breeding
pens for the following season. The marked pullets are placed in the
Laying Houses with the other pullets, but are never selected for
yearling breeders on our own Farm. In pens sold to others we
always furnish unrelated cockerels.
 Having hatched a sufficient number of chicks to produce about
four hundred cockerels, no further eggs are set from this pen, and, at
the end of the season, all the birds comprising this pen are sold.
This Method of line breeding hands down the laying quality which
has been so developed, and which is being increased from season
to season in an unbroken line, but inbreeding is absolutely avoided,
and the vigor of the stock is maintained.
Perhaps, in closing the chapter, nothing could be more apt than a
letter received from a Breeder of Crystal White Orpingtons, in the
neighborhood of one of the large Western Cities. The letter-head, in
large type, states, “Breeder of Crystal White Orpingtons, the Great
Winter Layer.” The contents of the letter is as follows:
“As I am now planning to go into the Egg business, and desire to
follow your method as closely as possible, and, while in this locality
there is not such a marked preference for the white egg over the
brown, still the White Leghorn, of a good strain, doubtless outlays
any other breed known, and the shape of its egg is such that it is
superior for table use, to any laid by the dark shelled family. It,
therefore, is my purpose, as rapidly as possible to work into a large
flock of Leghorns, with Corning stock as a basis.”
It will be noted that the gentleman is a breeder of Crystal White
Orpingtons, and prints in large type on his letter-head, “The Great
Winter Layer,” but that when it comes down to “brass tacks,” from the
standpoint of the hen which will produce an egg for table use, and
the hen that will give you the requisite number to make the dollars,
the Breeder of the Crystal White Orpingtons wants to put in the
Corning Strain of Single Comb White Leghorns.
 CHAPTER VI
Advantages of the Large Flock System—Reduces
Cost of Housing and Economizes in Time and
Labor
For many years the floor space per hen has been an interesting
study to anyone reading poultry literature, either in books or in
magazine articles.
Some fifteen years ago it was generally considered for a hen to do
at all well she must have at least twenty square feet of floor space.
Later, the number of feet was divided by half, and for some time ten
square feet was considered to be the very least a hen could possibly
do with. Then we come to the four square feet period, and this
created a great deal of controversy. Many writers declared that it was
impossible for any hen, no matter how housed, to do well in such a
restricted space. At times, some visionary writer pictured a flock in
one house, of what was then considered an enormous size. One
Professor of poultry went so far as to state that he had successfully
kept some three hundred hens in one flock, and had obtained most
satisfactory results. This statement, however, was denied by others,
and the Professor wrote an article in which he set forth that, while he
had done this, he would never think of suggesting that the average
poultry-keeper attempt it. In his statement there were some truths
that it is well to remember, namely, that the average poultry-keeper
would not give the flock the care and supervision necessary to keep
it in health. In other words, the poultry-keeper would not attend to the
necessary cleanliness, and disease would break out, and, in the
average poultry house, under such conditions, this would mean the
total annihilation of the flock.
 THREE STERILE LAYING HOUSES CONTAINING 4500 PULLETS, WITH A
FLOOR SPACE OF 7680 SQUARE FEET

Draughts the Stumbling Block

As economy of space and labor is one of the main factors in
getting a commercial profit where poultry is operated with, the large
flock system appealed most strongly to The Corning Egg Farm. Long
houses, under one roof, without divisions, had been attempted by
others, and the endeavor to discover the reason for the failures,
where this had been attempted, was a very interesting study. It was
found that the main stumbling block in houses of this type was
draughts. To eliminate the draughts was the problem we then
undertook to solve. It was found that if the houses were built in
sections of twenty feet, and the partitions which divided the house
into roosting closets were extended twelve inches beyond the
dropping boards, and were carried from the floor to the roof, the air
currents were broken up, and the difficulty of draughts was
overcome.
Houses, as we believed in constructing them, were expensive,
unless it was possible to carry a very large number of layers
successfully in them. In studying the two hundred and twenty-five
pullets as they worked contentedly in the No. 1 Laying House, which
was but twelve feet wide, we became convinced that it was perfectly
possible in a house sixteen feet wide by one hundred and sixty feet
in length to carry fifteen hundred layers. This, to be sure, allowed the
hen only a little over two square feet of floor space, with the dropping
boards included. But, as we figured it, the hen also had the entire
house for floor space, and, while it is true that fourteen hundred and
ninety-nine sisters were her near neighbors, they all enjoyed the
same large space to roam in. A house, then, of this size,
accommodating fifteen hundred layers, was not an expensive house
per bird, and, when you consider that the construction was such that
the up-keep was practically nothing, it became not only not an
expensive house, but really a very cheap one.
The success of the fifteen hundred layers in one house proved
itself at once, and we never have seen the slightest necessity for
altering the plan of the Laying House, as we first laid it out.

2,000 Birds to a House

The large flock system works economies, then, in housing, in the
amount of labor necessary to care for the birds, and in gathering the
eggs. And there is no doubt but that a house of considerably greater
length, with a flock ranging as high as two thousand birds, could
successfully be handled. In fact, on one farm which has been in
existence over twenty-five years, a Corning Method Laying House of
two hundred feet in length has been in operation now for twelve
months, and the owners write us that it is the most successful house
on their entire farm, and that as rapidly as possible they are
rebuilding all their Laying Houses, and making them of this type.
 CHAPTER VII
What is the Winter Layer?—The Properly Hatched
and Reared Pullet
Many people have a very erroneous idea with regard to getting
Winter eggs. They seem to think any hen should produce eggs in
Winter. The hen generally moults in the early Fall, and Nature has
provided this time of rest for her. The egg organs cease to produce,
for the hen finds she has all she can do to supply the necessary
material for her new dress, and this is a very serious drain on her
system. The natural time, however, for a pullet to begin to lay is
when she reaches maturity, and, as the pullet hatched in the early
Spring, properly cared for, should come into eggs in the early Fall,
the pullet, then, is the Winter layer.
It must still be remembered that the domesticated fowl of to-day is
a bird of evolution. In its wild state a pullet did not begin to lay eggs
in the Fall, and neither did she lay a large number of eggs at any
time. With the coming of Spring, and an abundance of succulent
green food, and large quantities of animal food in the shape of a
great variety of worms and insects, she laid and hatched her brood.
Therefore, to have successful Winter layers, it is necessary to
produce as nearly as possible the Spring-time conditions.
 INTERIOR LAYING HOUSE NO. 1 IN 1910

Must Feed Green Food

On The Corning Egg Farm, when the pullets are brought up from
the Range into the Laying Houses, the majority of them have already
been laying on the Range, and they are in fit condition to be brought
strongly into eggs. They are fed a large quantity of succulent green
food, in the form which, perhaps, is more delicious to the hen than
any other, that is, Sprouted Oats. The quantity of animal food in their
mash is increased, and, with the vigorous digging for the grain in the
deep litter, the problem of Winter eggs is solved, and from day to
day, the number of eggs coming from the pullet houses, increases
very rapidly.
On the other hand, the pullet which has completed its first ten
months of laying is well advanced in the moult, and is becoming a
yearling hen. Those qualifying under the drastic examination for
perfect type are selected for the next year’s Breeders, and are
removed to the Breeding Houses, which have been thoroughly
disinfected and put in the most sanitary condition to receive them.
Those not reaching the Corning Standard are marketed, as we sell
culls only to the butcher.
The aim in handling the yearling hen is not to get eggs from her
during the Winter, but to give her a long rest, and to build her up, and
put her in the pink of condition for the coming breeding season, and
it is the aim at The Corning Egg Farm to have as few eggs produced
as possible from the breeding pens until about the first of January,
when an increased amount of animal food is added to the daily ration
for the purpose of bringing the hens into eggs, and within a few days
there is a very rapid increase in the number of eggs from these pens.
It must be remembered that the profit in Winter eggs is made from
pullets, and to be successful in this line the Laying Houses must be
well stocked with them.
Yearling and two year old hens are the proper breeding females.
The Corning Egg Farm Method is one of continuous rotation, as
follows:
Incubator to Brooder House.
Brooder House to Range.
Range to Laying House. Those selected as coming up to the
Corning Standard go to the Breeder House.
At the end of the second year the Breeders are all sold for
foundation stock.
This gives an opportunity to the public to procure the very best
Breeders at a most reasonable price.
 CHAPTER VIII
A Great Laying Strain—The Selection of Breeders
to Produce It
The first requisite is to breed from a mature animal, from a real
yearling hen. The term “yearling hen” is a misnomer, for, when she is
twelve months of age she has not as a rule developed into a true
yearling hen. The female has five months of growth, ten months of
laying, and then she moults, which process varies in duration from
eight to ten weeks.

Eighteen Months Old

When she has completed the moult, her entire anatomy has
undergone a change, and she is a mature animal, about eighteen
months of age, a fit specimen to reproduce her kind, and her off-
spring will be strong and vigorous youngsters.
The great mortality one reads of among chicks can be traced more
to breeding from immature females than to any other cause.
The general method of selecting breeders for a great many years
has been by the use of “trap nests.” Surely the use of a mechanical
device is a poor method to determine what hens are proper for
breeding purposes, and really the trap nest tells you nothing.
In every pen there are daily a number of eggs which are not laid in
the nest at all. To what particular hen does the attendant credit eggs
found in hollows scooped out in corners under the dropping boards?
It is a peculiarity of “Biddy” that where she sees an egg she almost
always decides it is a good and proper place for her to lay another.
Thus, on some days, where trap nests are in use, it may be
necessary to make a great number of guesses as to which hen did
not lay in the traps, but on the floor.
 Trap Nests a Failure
There is another reason why trap nests really tell you nothing.
Take two females of a pen whose numbers are one and two. For the
first few weeks No. 1 surpasses her sister No. 2 in the production of
eggs. To this pen, clover has been the green food fed, and of this
ingredient the farm has run short. The shipment has been expected
daily but did not arrive, and, because of that failure, for four or five
days no other green food was provided. Then cabbage was resorted
to to take the place of the clover. The pen having been without green
food for a number of days was fairly greedy for it, and good, crisp
cabbage suits the palate of many hens exactly, and they are very apt
to overdo the matter in eating it. A great layer must be a large eater,
and so hen No. 1 gorged herself on the cabbage. Her digestive
organs were upset, and for a number of weeks she ceased laying,
while hen No. 2 continued to shell out a fair number of eggs. The
owner of these birds, when it came time for the selection of the
breeders, expressed his great disappointment over hen No. 1. She
had started so well, and then had blown up entirely, and so she is
passed up, and hen No. 2 is accepted as a breeder.
 ONE OF THE BREEDING HOUSES JUST AFTER MATING 1910

Now, if the anatomy of these two birds had been studied, it would
have been found at once that hen No. 1 was much better qualified to
take a place in the breeding pen than hen No. 2. The mere fact that
the trap nest record of any female shows a phenomenal number of
eggs laid in ten or twelve months does not necessarily prove that
she is a proper animal to breed from. Post-mortem examinations
show in many cases that they are freaks, and, while they have laid a
great number of eggs, there was much to be desired in regard to the
eggs, as to their size, shape, and color. As a matter of fact it would
have been a great mistake to have bred from such an individual.

Type Reproduces Type

It must be remembered that type produces type, and the only
proper way to select birds for the breeding pen which will produce
progeny capable of great egg production is to thoroughly understand
their anatomy. It is impossible to produce a great performer in any
line unless the animal is of a build capable of the performance. No
one would expect to breed a two-minute trotter from a Shetland
Pony.
The hen which is capable of becoming an ideal layer must have a
deep keel, a long body, and, as she faces out, she must have an
appearance of broadness, and must be the shape of a wedge back
to the point where the wings join the body.
The Large Flock System is carried on in the Breeding Pen on The
Corning Egg Farm, and it has been most successful. It has been
found that the small pen does not produce the high fertility
continuously which the Large Flock System does. During the season
of 1910, for long periods, the fertility ran as high as 96%, and as
early as the first of March it was above 90%. In the season of 1911,
eggs incubated in the early part of February, ran above 91%, and
during the season there were times when the fertility reached 97%.
The Breeding Pens are mated up two weeks before eggs are to be
used for incubation, and early hatched cockerels are used to head
these Breeding Pens. It has been found that the mating of cockerels
with yearling hens produces a very decided predominance of pullets,
and the youngsters are strong and vigorous from the start.
The proportion of mating is one to twelve, and the records of The
Corning Egg Farm show that by this method of mating the number of
cockerels produced, through the years that the Farm has been in
operation, has been as low as one-quarter, and as high as one-third.
The males to head the pens are selected with the same care that
the hens are. They are all perfect birds, of large size, and conform as
closely as possible to the standard requirements, without interfering
with the paramount aim of producing a Great Layer.
 CHAPTER IX
What is the Best Time to Hatch?
The question which is the title of this chapter is asked over and
over again. You see it propounded to the editor of almost every
poultry paper in the country. And it is a difficult one to answer,
because the various needs of different people are so diversified.
April and May are doubtless the natural hatching seasons for all
varieties. Climatic conditions are then kinder, the food which is
necessary for the production of many eggs, and eggs of the strong
hatchable kind, is supplied by Nature in great abundance, and the
young chick coming into life in these months finds a great variety of
natural food of the very best kind for growth awaiting it. In Spring
eggs run strongly fertile, and in every way Nature seems to lend
herself to successful hatching, and the starting of the young chick
properly on its journey.
The man, however, who is operating an egg farm, and has made
contracts for the delivery of a continuous supply of eggs to exacting
customers, cannot well afford to wait until these months to hatch in,
for it is necessary for him to have a large number of pullets reaching
maturity and beginning to lay, before his last year’s pullets reach the
moulting period and stop egg production. To accomplish this it is
necessary to have in his brooder house, by not later than the first
week of March, a goodly number of yellow babies. From that time on
he must keep them coming, so as to have a sufficient number a few
weeks apart to take the place of the yearling hens going into the
moult. In this way he will succeed in keeping up a continuous flow of
eggs.
It is true there is a danger in these early hatched pullets. They may
go into what is called the Winter moult, after laying well into the
month of December, but they will not all moult, and before there is a
marked shrinkage the later hatches will be laying strongly.
 The moult which occurs with early hatched birds does not last as
long as the moult coming in the regular season. The birds soon
return to the nest, and the house rapidly jumps back to a very large
output of eggs for the coming Spring months. Thus the great
increase in numbers helps to offset the decrease in price, and to
equalize the bank account.
It must be remembered, however, that Leghorns hatched up to the
25th of June make good Winter layers provided they are properly
cared for, and given the food and attention which produces a great
growth, and under such conditions one will find no difficulty in getting
them into laying eggs readily by the time they are five months of age.

An Interesting Experiment in Late Hatching

In the season of 1910 The Corning Egg Farm made a very
interesting experiment, in a large way, so far as late hatching goes.
We incubated two large batches of eggs, the first being set so that
the chicks hatched from the 18th to the 26th of July; the second
batch completed incubation August 15th. The resulting pullets from
these two hatches were some fifty odd over twelve hundred. We
carried them on Range until December 1st, and then placed them in
a Laying House by themselves. They had not begun to lay on Range
so far as we were able to discover, although many of the pullets had
the appearance of eggs. Almost from the start, after they were
placed in the Colony Houses, we fed them, in addition to the regular
Range ration, a good supply of Sprouted Oats each day. This was
done for the reason that of course the succulent green food had
passed away, and we consider it of vital importance that growing
birds be given the opportunity to gather a large supply of succulent
green food. The records show that within three days after the pullets
were placed in the Laying House we began to gather from one to
three eggs a day. Before December was over the house was
producing 10%; January saw 35% output of eggs, and before
February was very far advanced we were doing better than 60%.
There was a time in March when the House was yielding a 75%
output.
 SPROUTED OATS CELLAR

These birds laid strongly all Summer, and we were interested in

noting when they would start to moult. We had seen the statement
made a number of times that late hatched pullets were very late
moulters. In our experience, however, this did not prove to be true,
for this pen of birds moulted at just about the same time, and in the
same proportion, as the earlier hatches did.
We had frequently seen it stated that birds hatched in the very last
week of August, or the first week in September, would produce eggs
at the same time that the June hatched pullets would begin to
produce them. Our experience with June hatches, and we have had
four years of it, disproves this statement absolutely. We find that the
June hatched pullet, properly cared for, comes in quite as rapidly as
those hatched in April and May.
We do not wish to go on record as advocates of July and August
hatching, but we simply wish to show what could be accomplished if
a Breeder met with some misfortune, and was compelled to hatch
late or not at all.
 CHAPTER X
Succulent Green Food—Satisfactory Egg
Production Impossible Without It
A goodly supply of green food is necessary to all birds, the
growing chicken as well as the yearling hen, for it is a great aid to
digestion, helping to properly assimilate all foods as they are taken
into the crop, and passed through the great grinding mill of a
chicken.
There is no possible hope of a full egg supply from any Laying
House where a large quantity of green food is not fed daily. It may be
fed in many forms. Clover or Alfalfa (and we are now speaking first
of the Winter supply of green food) may be procured in a dry state,
and by properly scalding it with hot water it may be made to almost
live again, so far as its freshness and delightful odor go. In many
cases the preparation of Clover or Alfalfa spoils it. The water should
be quite at the boiling point, and it should be poured over, preferably
it should be put on with a sprinkling can. The method at The Corning
Egg Farm is to place whichever we are using of the Clover family in
pails, a given number for each Laying House, and as they stand in
rows the hot water is applied with a sprinkling can. The contents are
not allowed to steep, but as soon as the second wetting of the long
row of pails is reached they are placed on the delivery wagon and at
once taken to their destination. When the contents are emptied from
the pails they will be steaming hot, too hot for the birds to take at
first, and you will find them standing in a ring around the Clover, and
from time to time testing the heat. As soon as it is cool enough they
will devour it with great avidity.
Where Alfalfa is fed some flocks give considerable difficulty at first
as they do not seem to relish it, but after a short time they seem to
acquire the taste, and become very fond of it. It contains a higher
amount of protein than the ordinary Clover which can be bought in
the market, but in purchasing Alfalfa products one should be careful
not to buy a large quantity of dirt, but get what is known as “short
cut,” and have it carefully sifted.
By many people cabbages are considered a most excellent green
food for Winter use, but if they are chopped up and fed to the layers
considerable caution should be used in the feeding. They are very
apt to upset the digestive organs of the birds, and that means a very
decided decrease in the number of eggs. This is equally true of
Mangle beets and other roots which in many cases are used.

Sprouted Oats Best

At The Corning Egg Farm we are strong believers in Sprouted
Oats as a green food, and we now maintain a cement Cellar, with
good drainage, which is used for nothing else. The method of
sprouting oats is really very simple, and does not require the
arduous labor which one would imagine from numerous articles
written on the subject.

How They Are Grown on the Farm

We have frames three by six feet in size, built of ordinary boards,
but not matched material. The sides are about four inches high.
These frames are laid on the floor of the Cellar, and each frame is
filled with forty-eight quarts of oats spread evenly over the bottom.
We have a large sprinkler attached to the hose, and the oats are
thoroughly wet as they lie in the trays, and this wetting is repeated
every morning. In a temperature from fifty to sixty degrees we find
that the oats have started to sprout about the third day, and from this
on the growth is very fast. Parts of the oats in the frame will swell two
or three inches in places, above the surrounding mass of oats, and
we make it a practice to place the sprinkler directly on top of this
swelling, and it is found by so doing that the frame in a short time will
present a very even growth.
If the Sprouted Oats are fed when the green tops are from one
and a half to two inches in length the chemical quality of the oat is
not lost, and we really get a double ration when it is fed. If allowed to
go beyond this length, they are then just an ordinary green food.
In many instances we have noticed writers advocating soaking the
oats overnight, and then, for the next few days, to periodically stir
them. And in other cases writers advise, when they are placed in the
frames to turn the oats over. This is a serious mistake, for anyone
can readily see that the tender shoots, which grow most rapidly after
the third day, would be broken off, and where this occurs the oats will
rot.
Oats, of course, can be sprouted in sheds, or even out-of-doors, if
they are covered up so that the sun will not dry them out too rapidly.
A frame should be made in such a manner that the water sprayed
over the oats will slowly drain away. There are a number of different
contrivances now being placed on the market for sprouting oats, and
we have no doubt that, on small plants, some of them would prove
quite satisfactory. Where it is desired to sprout oats in a small way, in
the Cellar of one’s house, a rack can be built with run-ways for the
trays to slide on, with a space of two inches between the trays. By
thoroughly sprinkling the top tray the water will run down through
from one tray to another, and, as the growth progresses, the more
advanced ones can be moved up from the bottom of the rack, as
they require less water than those in a less advanced stage.
The oats sprout more quickly if grown and sprinkled in a fairly dark
place, and it must be remembered that too warm a temperature will
rot the mass after the growth has reached its fourth or fifth day.

Timothy and Clover Cut Green

As one enters The Corning Egg Farm, on the left of the drive,
there is about an acre of Timothy and Clover. This acre has been
very heavily fertilized and brought up to a high state of cultivation.
The Timothy and Clover grow so rapidly, and the growth comes in
such abundance almost before the snow is off the ground, that
cutting it as we do, so many rows each morning, it is impossible to
cross the entire plot before that which was first cut has almost grown
beyond the succulent point. To make a change for the hens we cut
this in the early Spring, and pass it through the Clover Cutter,