1

CHAPTER I EXECUTIVE SUMMARY

Introduction: The human musculoskeletal system (also known as the locomotor system) is an organ system that gives humans (and many animal species) the ability to move using the muscular and skeletal systems. It is made up of the bodys bones(the skeleton), muscles, cartilage, tendons, ligaments, joints, and

other connective tissue that supports and binds tissues and organs together. Its primary functions include supporting the body, allowing motion, and protecting vital organs. The skeletal portion of the system serves as the main storage system for calcium and phosphorus and contains critical components of

the hematopoietic system.

There are, however, diseases and disorders that may adversely affect the function and overall effectiveness of the system. These diseases can be difficult to diagnose due to the close relation of the musculoskeletal system to other internal systems. omple! issues and injuries involving the musculoskeletal

system are usually handled by a physiatrist (specialist in "hysical #edicine and $ehabilitation) or an orthopedic surgeon. #usculoskeletal pain affects the bones, muscles, ligaments, tendons, and nerves. It can be acute (having a rapid onset with severe symptoms) or chronic (long%lasting). #usculoskeletal pain can be locali&ed in one area, or widespread.

'ower back pain is the most common type of musculoskeletal pain. (ther common types include tendonitis, myalgia (muscle pain), and stress fractures. )nyone can e!perience musculoskeletal pain. It is most often caused by an injury to the bones, joints, muscles, tendons, ligaments, or nerves. This can be caused by jerking movements, car accidents, falls, fractures, sprains, dislocations, and direct blows to the muscle. #usculoskeletal pain can also be caused by overuse. "ain from overuse affects **+ of adults. (ne cause is poor posture or prolonged immobili&ation. #usculoskeletal fitness can be operationally defined by measurements of joint fle!ibility, muscular strength, muscular power, and muscular endurance. There is a limited body of scientific evidence that indicates that musculoskeletal fitness is related to health status (,-,./) and is a predictor of mobility, disability, and independent living in the elderly (0,1,,2,,1,.-). Thus, measures of musculoskeletal fitness are often performed as part of health%related fitness tests, such as the anadian "hysical )ctivity, 3itness and 'ifestyle )ppraisal

( ")3')) (*), the most widely used standardi&ed health%related fitness appraisal in anada. The 4orld 5ealth (rgani&ation suggests health is a state of complete physical, mental or social well%being and not merely the absence of disease or infirmity. "hysical health includes such characteristics as body si&e and shape, sensory acuity, susceptibility to disease and disorders, body functioning, recuperative ability and the ability to perform certain tasks. (ne aspect of physical health is the musculoskeletal system, which consists of * components6

muscular strength, endurance and fle!ibility. #uscular strength (dynamic) is defined as the ma!imum force a muscle or muscle group can generate at a specific velocity. #uscular endurance is the ability of a muscle or muscle group to perform repeated contractions against a load for an e!tended period of time. 3le!ibility has . components, dynamic or static, where dynamic fle!ibility is the opposition or resistance of a joint to motion, that is, the forces opposing movement rather than the range of movement itself. 7tatic fle!ibility is the range of motion about a joint, typically measured as the degree of arc at the end of joint movement. If strength, endurance and fle!ibility are not maintained,

musculoskeletal fitness is then compromised which can significantly impact physical health and well%being. #any health benefits are associated with musculoskeletal fitness, such as reduced coronary risk factors, increased bone mineral density (reduced risk of osteoporosis), increased fle!ibility, improved glucose tolerance, and greater success in completion of activities of daily living ()8'). 4ith aging, the performance of daily tasks can become a challenge. )dditionally, falls, bone fractures and the need for institutional care indicate a musculoskeletal weakness as we age. The earlier in life an individual becomes physically active the greater the increase in positive health benefits6 however, becoming physically active at any age will benefit overall health. Improved musculoskeletal fitness (for e!ample, through resistance training combined with stretching) is associated with an enhanced health status. Thus, maintaining musculoskeletal fitness can increase overall 9uality of life.

Background of the Stud :

)dventist 5ospital serves the medical needs of people throughout the

agayan

:alley. It is a non% stock, non% profit and self% supporting private hospital with -; beds. It is affiliated to more than -;; healthcare institutions worldwide operated by the 7eventh 8ay )dventist hurch licensed as Tertiary 'evel 5ospital by the

8epartment of 5ealth (8(5) and accredited by the "hilippine 5ealth Insurance orporation ("hil5ealth) as < enter for =uality>. #ember of the "hilippine 5ospital )ssociation, "rivate 5ospitals )ssociation in the "hilippines and )dventist 5ealth 7ystem? )sia. It is recogni&ed internationally for its 9uality service. The first and only hospital certified as I7( 1;;,@.;;; in $egion II and first )dventist 5ospital in the "hilippines certified with I7( 1;;,@.;;A by TB: 7B8 )sia "acific, 'td.

7ervices and 3acilities@

)utologous 7tem ell Therapy )nesthesiology haplaincy? 5ealth Cducation hemotherapy 8ental 7ervices 8iagnostic Imaging T% 7can .8 Ccho *8 Bltrasound D% $ay

8ialysis 8ietary? anteen? 5ealth 3oods

Clectrocardiogram (C E) .0 5ours Cmergency 7ervices Cndoscopy #edicine Internal #edicine ardiology 8ermatology 8iabetology CCFT Cndocrinology

Eastroenterology Eeriatric #edicine 5ematology #edical (ncology "ulmonology "sychiatry 'aboratory Glood Gank E2"8 onfirmatory Testing

Fewborn 7creening Gacteriology 7pecial Tests (bstetrics and Eynecology (b%gyne Eyne (ncology "ediatric and )dolescent Eynecology "athology "ediatrics Eeneral "ediatrics "ediatric 5ematology "ediatric (ncology "ediatric ardiology

.0 5our "harmacy "hysical Therapy 7urgery Eeneral 7urgery CCFT CFT% 5ead and Feck 7urgery Feuro 7urgery (phthalmology (rthopedic Brology

7moking

essation "rogram ampaign

Greast 3eeding

Furse Training "rograms ritical are Fursing

I: Therapy Fursing (ther 7pecialty )reas (($, 58B, C$) Santiago Cit

(fficial 7eal

Countr Region Pro!ince "i#trict

"hilippines agayan :alley ($egion II) Isabela (0th 8istrict ity) of Isabela and

7antiago $ounded Cit hood Baranga # %o!ern&ent ' Ma or Area ' Tota( ' Tota( ' "en#it Ti&e *one +IP Code Inco&e c(a## #ay ,A-A

Huly 2, ,110 */ Hoseph 7alvador Tan ./-.;; km. (,;2.,A s9 mi) ,*.,A;0 0A;?km. (,,*;;?s9 mi) "5T (BT IA) **,, ,st class 6 independent component city

Po)u(ation (.;,;)

Hi#tor

The origin of 7antiago

ity can be drawn from the first native settlement arig $iver

discovered by the early 7panish missionaries at the bank of the old (now 8iadi $iver) from which its original name,

arig, was derived. The early

inhabitants were the Eaddangs and the Ibanags. 4hen the 7panish settled in, the city was named "ueblo of 7antiago )postol de arig, with7antiago as the

7panish name of 7aint Hames the )postle. In the early ,1-;s, the #unicipal

10

"resident :icente

arreon changed the name to simply 7antiago. 7antiago

remained a municipality for A0 years. 7antiago was originally a part of the province whole agayan (comprising the

agayan :alley region), which was reorgani&ed as a political subdivision

in ,-A* with Fueva 7egovia as its capital. (n #ay ,, ,A-2, when the "rovince of Isabela was carved out by a $oyal 8ecree, 7antiago was among the towns relin9uished to the newly created province. The first five barrios after the adastral survey in ,1./ were "atul, Gatal, Fabbuan, Guenavista and

8ubinan. It was said that there were only about three 3ilipino%owned sari%sari stores in 7antiago in ,1,/. The settlers ac9uired most of their merchandise and other provisions from hinese traders in Cchague, the landing &one for products agayan

intended for 7antiago and other towns, owing to its pro!imity to the $iver.

It was when the :illa%:erde Trail was opened when things were set in motion. It facilitated the entry of immigrants from various provinces in 'u&on to the agayan :alley and 7antiago absorbed a si&able share of these travelers.

The new route served as an impetus for growth and introduced new technologies and business opportunities. 7antiago survived through world wars, although badly damaged, and from then on developed to become the leading commercial and industrial city in agayan :alley. In ,10., occupied by the Hapanese forces entered in the town of 7antiago.

11

In ,10-, founded to the liberation in the town of 7antiago province of Isabela beginning the 3ilipino soldiers of the ,st, .nd, ,,th, ,.th, ,*th and ,-th Infantry 8ivision and the B7)3I"%F' ,,th Infantry $egiment of the "hilippine ommonwealth )rmy, the ,st Infantry $egiment of the "hilippine

onstabulary and the recogni&ed guerrilla fighter unit against the Hapanese Imperial forces under defeated during 4orld 4ar II. (n 8ecember ,/, ,11*, the bill converting 7antiago into an independent component city was approved by the 'ower 5ouse. (n the following year, the 7enate ommittee on 'ocal Eovernment approved another public hearing dated

3ebruary .*, ,110. (n #ay -, ,110, by virtue or $epublic )ct //.; signed by 5is C!cellency, "resident 3idel :. $amos, 7antiago was pronounced as an independent component city, the first in the agayan :alley $egion. This made 7antiago, self%

governing and autonomous city from the rule of the provincial governor. $epublic )ct A-.A repealed this statute transforming it back to a component city. It was not until 8ecember .1, ,111, when the 7upreme ourt contested the validity of

the latter decision and favored 7antiago to be once again an independent component city.

Econo& 7antiago ity is the gateway of agayan :alley. "eople from neighboring

towns go to 7antiago

ity to do their business. )s the only Independent

12

omponent

ity in $egion II, most of the establishments seen in #anila can also

be found here. The ity of 7antiago is an independent city located in

Forthern 'u&on island of the "hilippines. It is surrounded by four provinces (Fueva :i&caya, Ifugao, =uirino and Isabela) and is the gateway to the vast lands of agayan, Isabela and =uirino. )ccording to the .;,; census, it has a

population of ,*.,A;0. 7antiago is situated *.2 kilometers north of #etro #anila. The city sits on a vast area of predominantly flat and fertile land in the surrounded by the the east and the agayan :alley,

araballo #ountains to the south, the Ereat 7ierra #adre to

ordillera #ountain $ange to the west.

7antiago

ity is

agayan :alleyJs pioneer city. Its cityhood motivated

other towns to grasp for more progress and to uplift the peopleJs standard of living. 7antiago ity has highly e9uipped facilities in health, education and

security making it a first choice in terms of settlement. 5ome of several business enterprises, banking institutions, educational entities, as well as manufacturing companies, the ity of 7antiago is considered the

ommercial and Industrial enter of agayan :alley. $obinsons 'and orporation has recently launched $obinsons "lace agayan :alley. :ista 'and and 'ifescapes, amella Isabela. It has recently

7antiago as its pioneer mall in Inc. entered

agayan :alley by building

launched another project named as

amella 7antiago. The head%office of Erupo

13

#arilens, the largest homegrown corporation in the region, is in 7antiago Three of the biggest T: networks in the country

ity.

(i.e.)G7%

GF, E#)/,T:-)stationed their regional networks in the city. 7an #iguel orp., "epsi ola, "urefoods,8igitel and "'8T also operate in the city while

different car companies abound(i.e.#itsubishi, Fissan, Isu&u, 5yundai, KI), 3ord, other car companies as well as Lamaha and 5onda #otors). The Fational 3ood )uthority competes with local traders to stabili&e prices. 7antiago ity houses some of the biggest hospitals in the region. The

Bniversity of 'a 7alette 5ospital is said to be the biggest having a capacity of at least *-; bed. 8e :eraJs #edical enter, allang Eeneral 5ospital and agayan ity

:alley 7anitarium are also e9ually e9uipped private hospitals. The 7antiago Cmergency 5ospital and 3lores 5ospital are now considered #edical enters.

Fotable school institutions located in the city are the Bniversity of 'a 7alette and Fortheastern 7outhern Isabela operating in the city. %eogra)h ollege, one of the oldest schools in the region. The

ollege of )rts and Trades is the biggest vocational school

14

The total land area the city is A;+ flat or nearly level land in the portions of northwestern, eastern and western parts of the city. 4hile adjacent areas have gently undulating and moderately rolling areas, and the remaining areas constitutes steeply undulating and rolling lands. The Galintocatoc 5ills is the highest point in the city. The geographic coordinate of the city lies between ,2M*-;;> to ,2M0/*;> north latitude and ,.,M.-;;> to ,.,M*/;;> east longitude.

)baya (ld $esidence

Baranga #

15

7antiago

ity is politically subdivided into */ barangays.

entro ("ob.)

4est

)bra )mbalatungan Galintocatoc Galuarte Gannawag Forte Gatal Guenavista (Brban) abulay alao Cast ("ob.)

$osario (Brban) 7agana 7alvador 7an )ndres (Brban) 7an Isidro 7an Hose 7inili 7insayon (Brban) 7anta $osa :ictory Forte ("ob.) :ictory 7ur (Brban)

8ivisoria

8ubinan ("ob.) 8ubinan (Brban) 'una #abini ("ob.) #alvar ("ob.) Fabbuan Faggasican "atul

Cast

4est

alao 4est ("ob.) alaocan (Brban) :illa Eon&aga

entro Cast ("ob.)

"laridel (Brban) $i&al (Brban)

:illasis ("ob.)

"e&ogra)hic# Po)u(ation Cen#u# of Santiago Cit Year Po), -. ),a,

16

/001 2333 2334 23/3

1A,-0. ,,;,-*, ,.2,.00 ,*.,A;0

N ..*.+ ,.1.+ ,./;+

%o!ern&ent The city is governed by a mayor%council system. There are ,; ity

ouncilors. The council is the official government body of the city, it is also known as 7)FEBFI)FE ")FE'BFE7(8. ouncil agenda is presided by the

ity :ice #ayor. Fo native was ever elected mayor of 7antiago since the "hilippine became a ommonwealth and $epublic.

8uring the #iranda 3lagship, the city Eovernment adopted the parental )!$ 5ybrid rice seed production as its flagship program for agriculture, which produces the offspring 3, 5ybrid rice seed. This rice variety makes phenomenal yield of .01 per ha. doubling the income of 7antiago and is e!pected to bring 7antiago ity farmers per cropping,

ity over . billion in income and also additional

ta!es of ,/ million and the national government of ** million per year. )fter the previous leadership, The Favarro )dministration added more life in culture and strengthen the livelihood of the people. The FavarrosJ spearheaded a uni9ue program for farmers in planting on mid%summer and harvest by early 7eptember side%by%side in focusing on high%value fruits. 5i#t of the current e(ected officia(#

17

ongressman Eiorgidi G. )ggabao (0th 8istrict of Isabela and 7antiago ity)

#ayor Hoseph 7alvador Tan :ice%#ayor #arcelino abucana, Hr.

Sangguniang Pang(ung#od Me&6er#

oun. )rlene )lvare& oun. 7i9uian eline )baya%

oun. Ficky Gautista oun. 5e! )lvare& oun. )ndong 8irige oun. 'una Grenda $agsac%

oun. "andong 'ugod oun. :inchy )ggabao oun. )ysen #arrero oun. Kathrina 7able

Tag#

Investment 5ub of the Forth

=ueen

ity of the Forth

Investment 5ub of the Forth "remier ity of agayan :alley "ioneer ity of agayan :alley ommercial )nd Industrial enter of $egion .

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Cu(ture The ity celebrates Pattaradday Festival or dubbed as Santiago Day.

"attaradday is an Ibanag word which means unity. It celebrates the unity of the ethno%linguistic groups that have merged in the city to make it the melting pot of culture of $egion II and contributed to the citys progress and development%unity in action. it is celebrated every #ay ,% #ay 2 the founding anniversary of 7antiago. In .;;/, The ity was given a "residential )ward for the #ost hild%

3riendly ity under the leadership of former #ayor Favarro.

Transportation 7erving as a bridge to the regionJs provincial network, numerous bus terminals are present in the city. These include, :ictory 'iner, Felbusco, 3lorida, Galiwag Transit, Forth 7tar Gus, 8agupan Gus, $C# 'iner,)uto Gus among others. Gy air via auayan ity airport

The 7antiago

ity Integrated Terminal has also been established to cater

for public vehicles that operate from nearby provinces and localities to the city. Bu# Co&)anie#

:ictory 'iner 3lorida Forthern 'u&on Gus line (Felbusco) Galiwag

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"efinition of Ter&#:

5uman musculoskeletal system % is an organ system that gives humans (and many animal species) the ability to move using the muscular andskeletal systems. The musculoskeletal system provides form, support, stability, and movement to the body. #usculoskeletal pain % affects the bones, muscles, ligaments, tendons, and nerves. It can be acute (having a rapid onset with severe symptoms) or chronic (long%lasting). #usculoskeletal pain can be locali&ed in one area, or widespread.

#usculoskeletal rehabilitation program O a doctor%supervised program designed for people with impairments or disabilities due to disease, disorders, or trauma to the muscles or bones. #usculoskeletal rehabilitation programs can often improve functional capacity, reduce symptoms, and improve the well%being of the patient.

5ot "acks@ 5ot packs, also known as hydrocollator packs, warm tissue by conduction. They typically consist of canvas bags filled with silicon dio!ide that absorbs many times its own weight in water. 5ot packs are immersed in a hot water bath, and are removed from the bath when needed, wrapped in 2 to A layers of toweling or an insulating cover, and applied to the patient. They are used to heat the body part prior to physical therapy. To avoid scalding, e!cess water should be drained from the pack and the covering towels or pad should be checked for e!cessive

20

dampness. The packs cool slowly and can remain warm for *; or more mins. #edicare considers hydrocollator units as non%covered institutional e9uipment.

Clectric 5eating "ads@ Gecause electric heating pads do not cool spontaneously, use should be limited to .; mins to avoid the risk of burns. There is no evidence that the use of circulating%water heating pads or moist electric heating pads provide superior outcomes, in terms of enhancing recovery of function, compared to standard electric heating pads. )ccording to #edicare 8#C #) policy, it has not been

established that a moist electric heating pad or water circulating heat pad with pump is reasonable and necessary compared to a standard electric heating pad. The policy states that, because a water%circulating heating pad system is not medically necessary, a replacement pump or pad is not reasonable and necessary. )ccording to 8urable #edical C9uipment #edicare )dministrative ontractor

(8#C #) ) policy, standard electric heating pads are necessary to relieve certain types of pain, decrease joint and soft tissue stiffness, rela! muscles, or reduce inflammation. 8#C #) policy states that a heating pad is not

reasonable and necessary to treat pain due to peripheral neuropathy, including but not limited to diabetic neuropathy. In uncomplicated cases, heat treatments of this type, as well as paraffin baths, may not re9uire the skills of a physical therapist.

21

5eat 'amps@ 5eat lamps warm tissues by conversion (i.e., by converting radiant energy to heat). 5eat lamps often use .-;%4att incandescent bulbs and are usually placed about 0; to -; cm from the patient. Gecause ordinary incandescent light bulbs produce large amounts of infrared energy, special infrared sources (e.g., 9uart&, tungsten) are seldom necessary. 5eating rates and ma!imum

temperatures are controlled by adjusting the distance between the lamp and the patient. 5eat lamps may be preferred over hot packs where the patient is difficult to position or cannot tolerate pressure. 5eat lamps may also be easier to use than hot packs. )ccording to 8#C #) policy, the safety and effectivness of

using a heat lamp in the home setting is not established.

"araffin Gaths@ "araffin baths are primarily used to treat contractures, particularly for patients with rheumatoid arthritis, hand contractures, or scleroderma. The typical paraffin bath consists of a container filled with appro!imately a ,@/ mi!ture of mineral oil and paraffin maintained at -.P to -0P . )lthough paraffin%oil mi!tures can be

heated in a double boiler or stove, small commercial units are available for home use, which have the advantages of ease of use and increased safety. The patient may either continuously immerse the treated part for .; to *; mins, or may repetitively dip and remove the treated area from the paraffin.

Bltrasound@

22

Bltrasound is sound above the limits of human hearing. The therapeutic effects of ultrasound result from the conversion of sound to heat energy. Bltrasound diathermy typically employs fre9uencies between ;.A and , #5&. Bltrasound diathermy is considered a deep heating modality in that most absorption occurs far beneath the skin. It is most commonly used to treat tendonitis and bursitis, musculoskeletal pain, degenerative arthritis, and contractures. #a!imal heating may be limited by deep tissue factors and not by skin tolerance. Bltrasound may be applied directly by placing the applicator on the skin, or indirectly by immersing the body part and applicator in a water%filled container. Gecause of the importance of appropriate techni9ue and inherent dangers, ultrasound diathermy should be applied by a trained attendant and the devices are not appropriate for unsupervised home use.

7hort%4ave 8iathermy@ 7hort%wave diathermy uses radio waves to heat tissue conversively6 tissue is heated by the actions of a rapidly alternating electrical field. Gecause of the inherent risks involved in application of this deep heating modality, short%wave diathermy machines are inappropriate for unsupervised use at home.

#icrowave 8iathermy@ #icrowave diathermy involves the use of microwaves for heating tissues, and offers an advantage over short%wave diathermy in treating small areas in that

23

they can be relatively easily focused. 5owever, microwaves generally do not penetrate tissue as deeply as short%waves. #icrowave diathermy has been used primarily to heat relatively superficial muscles and joints. #icrowave diathermy is used relatively rarely, and

indications for which microwaves would be appropriate often are treated with superficial heat, short%wave diathermy, or ultrasound. Gecause of the importance of appropriate application techni9ue and the inherent risks of this deep heating modality, microwave diathermy machines are inappropriate for unsupervised home use.

Infrared 5eating "ads@ )n infrared heating pad system consists of a pad or pads containing mechanisms (for e!ample, luminous gallium aluminum arsinide diodes) that generate infrared (or near infrared) light and a power source. )ccording to 8#C #) policy, there

are no indications for which these devices have been demonstrated to have any therapeutic effect. 8#C #) policy considers these devices and any related

accessories not medically reasonable and necessary. )s a heating device, infrared heating pads have not been shown to be more effective than electric heating pads and hot packs, despite their greater cost.

TE7S Transcutaneous electrical nerve stimulation has been found to be ineffective for lower back pain, however, it might help with diabetic neuropathy.

24

Tran#cutaneou# e(ectrica( ner!e #ti&u(ation 8TE7S9 is the use of electric current produced by a device to stimulate the nerves for therapeutic purposes. TCF7 by definition covers the complete range of transcutaneously applied currents used for nerve e!citation although the term is often used with a more restrictive intent, namely to describe the kind of pulses produced by portable stimulators used to treat pain. The unit is usually connected to the skin using two or more electrodes. ) typical battery%operated TCF7 unit is able to modulate pulse width, fre9uency and intensity. Eenerally TCF7 is applied at high fre9uency (Q-; 5&) with an intensity below motor contraction (sensory intensity) or low fre9uency (R,; 5&) with an intensity that produces motor contraction.

25

CHAPTER 2 MA7A%EME7T ASPECT

#usculoskeletal fitness is an important and inade9uately appreciated component of overall health and well%being. 4ellness as it applies to strength and conditioning has numerous benefits. It allows maintenance of functional independence for longer periods in older adults. It impacts the metabolic capabilities of children and adults affecting the ability to maintain an ideal body weight. It has been shown to influence the prevalence and possibly the prevention of many musculoskeletal disorders such as muscle sprains, low back pain, osteoarthritis, osteoporosis, shoulder instability, and knee stability and pain. The #usculoskeletal (utpatient $ehabilitation 7ervice, helps people recover from traumatic injury and illness, hip fractures and joint surgery. It could be the result of serious injuries in a car accident, a long illness in hospital, or a broken hipfrom a fall on an icy sidewalk. 7uddenly, the hundreds of movements,

26

actions and activities that we perform each day are impossible. 4e help individuals regain their strength, physical abilities and independence.

The

ustomer The target customers are the people of 7antiago ity and neighboring

towns who are suffering from different kinds musculoskeletal diseases.

The Cmployees )side from (rthopedic, there is also a need for a nurse who at the same time will act as secretary and receptionist who will accept and entertain the clients and a physical therapy who will help the patient as they undergo the rehabilitation program.

The

ommunity The people of 7antiago ity and neighboring towns will be assured of

accessing to an advanced musculoskeletal wellness center that will cater to the patients with musculoskeletal diseases and injuries.

The Eovernment The ity of 7antiago will benefit of this wellness center through ta!es.

:6;ecti!e#:

27

,.

To improve strength and coordination and return the patients to their previous levels of function and performance.

..

To help the patient return to the highest level of function and independence possible, while improving the overall 9uality of life% physically, emotionally, and socially.

28

:rgani*ationa( Chart:

Ho#)ita( "irector

:rtho)edic Surgeon

Ph #ica( Thera)i#t

Secretar = 7ur#e

CHAPTER <

29

MAR>ETI7% ASPECT

Ser!ice# :ffered: ,. $ehabilitation 7ervices a. "arallel Gar b. Training 7tairs .. 5ot "acks@ *. "araffin Gaths 0. #usculoskeletal ultrasound

5. TE7S
2. 7tem ell Treatment /. 7urgery

Market A##e##&ent The Cit of Santiago is an independent city located in

Forthern 'u&on island of the "hilippines. It is surrounded by four provinces (Fueva :i&caya, Ifugao, =uirino and Isabela) and is the gateway to the vast lands of agayan, Isabela and =uirino. )ccording to the .;,; census, it has a

population of ,*.,A;0. 7antiago is situated *.2 kilometers north of #etro #anila. The city sits on a vast area of predominantly flat and fertile land in the surrounded by the the east and the agayan :alley,

araballo #ountains to the south, the Ereat 7ierra #adre to

ordillera #ountain $ange to the west.

30

Marketing Strateg To introduce the #usculoskeletal 4ellness following will be done@ a. Tarpaulins? 7treamers Tarpaulins and streamers will be put to strategic places so that people of 7antiago ity and nearby towns and cities will be aware enter in $egion . will enter to potential patients, the

that an )dvanced #usculoskeletal 4ellness soon be in b. 3lyers agayan :alley )dventist 5ospital.

3lyers will be available to the information desks of hospitals and clinics around $egion ..

c.

alling

ards

alling cards will be given to colleagues and patients to inform them about the #usculoskeletal 4ellness enter in agayan

:alley )dventist 5ospital and the services that they can avail in the said 4ellness enter.

d. $adio )dvertisement

31

The patients that will not be informed by the other marketing tools will be informed through radio advertisement because listening to radio, be it )# or 3# is a favorite past time of the Isabelinos.

32

CHAPTER ? TECH7ICA5 ASPECT

5ocation: )dventist 5ospital, #abini, 7antiago ity

Machine= E@ui)&ent: Machine 5ot "acks Clectric 5eating "ads 5eat 'amps "araffin Gaths Infrared 5eating "ads Infrared Bltrasound 7pine Traction #achine Transcutaneous Clectrical Ferve 7timulation #achine Ite&# needed . . , , , , , .

3igure ,

33

C(inic Hour#: #onday% 7aturday @ A@;; )# O -@;; "#