Initial Title: PROHEALTH: Physiotherapy Rehabilitation and

Research Center for Musculoskeletal Conditions

Chapter I

Introduction

1.0. Introduction

As a person ages comes with an increase of health-related complications experienced. These said

complications, may it be chronic, injury, disease and etc…, can have an apathetic effect on the

social, mental and physical aspects of the diseased. Musculoskeletal conditions have been a

prevalent factor in the consensus of disability. It contributes the most in the global percentage of

disability. According to the World Health Organization, musculoskeletal conditions are typically

characterized by pain often persistent and limitations in mobility, dexterity and functional ability

resulting a decrease on an individual’s ability to work and participate in social affairs associating

with the mental health of the recipient, and at a more broader concept, the overall performance of

the community. As listed by the International Classification of Diseases, musculoskeletal

conditions can vary from over 150 ailments that affects the locomotor functions; associated with

the muscles, bones, joints and associated tissues such as tendons and ligaments. (ICD, 2016) These

conditions can range from those that acute pain due to injury, such as fractures, sprains and strains,

to chronic conditions associated with ongoing pain and disability. (WHO, N.D)

Physical rehabilitation and its allied field of Physical Medicine promotes not only in restoring an

individual’s motor functions but also studies the root of these symptoms. This process
strengthening the core body of a person as well as to educate the mental state of each patient on

confronting different situations. (Eberhard, 2008) It is designed to restore function and quality of

life by means of therapeutic modalities, manual therapies, therapeutic exercises, and patient

education. When these therapies are chosen correctly, initiated at the right time, individualized to

the patient, and implemented in a way to ensure patient compliance, then they offer significant

potential benefit with usually minimal risk. (Wyss and Patel. 2007) Physical rehabilitation

concerns itself with providing physical healing methods for different kinds of injuries and illnesses

especially in the terms of musculoskeletal conditions.

1.1 Background of The Project

According to the World Health Organization, Musculoskeletal conditions are the leading

contributor to disability worldwide, with lumbar pain being the leading cause globally. Over a

billion people, or about 15% of the world’s population, are estimated to live with some form of

disability. In accord to the International Classification of Functioning, Disability and Health refers

disability to an impairment, activity limitation or participation restriction that is the result of the

interaction between health conditions and environmental and personal factors. Disability is

affected by factors of body structure of an individual, the activities an individual may participate,

the lifestyle of an individual and the environmental factors that affect these experiences (WHO

N.D)

For many developing countries such as the Philippines, manpower and resource are of outmost

importance as it greatly benefits the economy. Blue-collared worker especially those of production

has seen a higher chance of injury within the workplace due to the increased physical labor

compared to other professions. The economic performance of the Philippines of the year 2011

and 2013 has found a significant increase. Rising from 5.1% to 7.2%. This has resulted an inflation

in the demand for steel products having a consumption growth of 61% from year 2010 up to 2013

was. As based from the beforementioned data, the number of musculoskeletal disorders

experienced by the worker has significantly raised from 31,096 in year 2011 to 51,110 in year

2013, resulting to an increase of 39.16% in occupational disorders. (Philippine Statistics

Authority V.D.)
The rehabilitation industry in the Philippines, on-paper is an unmet need. In the Philippines,

rehabilitation services are limited. These services are particularly in Public Health Sectors or

Government funded Hospitals and in Level III Hospital mostly found in major cities. (PARM,

2017) With most specialists in the field are found in NCR. About 16 per thousand of the country’s

population had disability of the 92.1 million household population in the country, 1.44 million

persons or 1.57 percent had disability, based on the 2010 Census of Population and Housing (2010

CPH). Nationwide in 2011, there were 305,729 low-income households with members having

disabilities. The recorded figure of persons with disability (PWD) in the 2000 CPH was 935,551

individuals, which was 1.23 percent of the household population. (CPH, 2010)

1.2. Statement of The Problem

Hospitals nationwide, inclusion of those in NCR, do not have enough positions for

Physiotherapists and Occupational therapists, resulting for newly graduates to seek employment

oversees. Due to limited primary healthcare services in the Philippines gives an explanation as to

why rehabilitation is given low priority in comparison to other forms of medical servies. According

to Olavides Soriano an estimate of eight million people with disabilities in the Philippines have no

or limited access to therapy outside of the private health care. The WHO recognizing the

importance of affordable rehabilitation as it ensures healthy lives and promotes well-being of the

individuals as such these services support them to remain independent, participate in education, be

economically active and live meaningful lives. To effectively assimilate the possible benefits of

investing in therapy and rehabilitation in the Philippines the needs of people with disabilities must

first be considered.
In the Philippines, vocational rehabilitation falls under the National Occupational Safety and

Health of the Department of Labour and Employment and the National Council for the Welfare of

Disabled Persons. At present, vocational rehabilitation to address work-related injuries in the

Philippines are provided by institutions in private sectors. Community based in barangays however

fathoms only 2% of people with disability to have access to rehabilitation services. According to

Olavides Soriano, occupational rehabilitation in the Philippines does not differentiate between

people with general disabilities and occupational injuries; these services therefore are addressed

by mortality and sick leave rather than the enhancement of physical, psychological and social

aspects of daily life. An argument can be made that the examination of the effectiveness of

occupational rehabilitation in the Philippines could lead to the provision of a systematic

understanding, generation and mandatory reporting of data which would promote the delivery of

such services.

With musculoskeletal complications not only limited to physical injuries but also to other

spectrums of illnesses comes with a large ammount of patients, in which the current health care

facilities cannot accommodate. According to the Philippine Statistics.

Authority (2013) in 2000 there were 935,551 disabled people which has increased to 1,443,000

in 2010. In terms of age distribution almost 60% are from the 15-64 age range, majority of whom

are at a working age. With these, there are many conditions where therapy and rehabilitation could

make a significant contribution to improving the lives of those affected; these include low back

pain, stroke, ischemic heart disease, diabetes, road Injuries, neck pain, falls, and other
1.3. Significance of The Study

As of date Physical rehabilitation has always been an unmet concern in the Philippines. The

proposed project will be beneficial to the local communities in the province especially towards the

professionals, may it be blue or white-collared jobs who experiences musculoskeletal conditions

that affects their lives. With Physical rehabilitation not being accessible towards the public;

available only in either in small clinics or Level 3 Hospitals; these conditions are usually left

untreated until to the point of the condition to worsen. (PARM, 2017) The project will help these

professionals to recuperate and treat these conditions in order to reduce the risk of on the job

injuries and to live their lives as normal as possible

With Physical rehabilitation being an in-demand course, lack of manpower can only be attributed

to lack of job opportunities. Majority of Physiotherapists from the Philippines migrate to the other

countries, usually 1st world or 2nd world, as rehabilitation is a much more mainstream service in

contrast to the developing countries, such as Philippines. (PARM, 2017) The proposed project

will not only adhere to the lack of manpower in specialized field of Rehab Medicine but will also

provide more job opportunities for the local professionals within the province.

Philippines is a country susceptible to natural disasters. With disasters having a direct correlation

to the number of risks and emergency of disabilities. (World Disaster Report 2007) The proposed

project will greatly benefit the province especially during trying times of a natural disaster if one

would ever occur.

According to Soya Mori, the amount of data in Philippines pertaining to disability is either limited

or too general. This contributes to the lack of response in the prevalent issue of disability within

the country. The proposed project will also include a separate facility where areas data on disability

within the province can be and analyzed for further use. These will help with the lack of specific

statistics in disability within the province. Facility-based survey will be a model for the proposed

project. These data can help not only the services of the center but also help lawmakers in further

understanding the need of the disabled within the specific area.

1.4. Project Goals and Objectives

The aim of the project is to educate and provide the unmet need for rehabilitation in the area and

to provide a facility that will both passively and actively improve the disability condition within

the province. Offering accessible service to the public and minimize the conventional negative

aspects of health facilities towards its patients. The goal is to fit the ideal mold of a Rehabilitation

Medicine facility in mainstreaming accessible services in rehabilitation to the country.

Specifically, it aims to answer the following:

1. To establish a provincial paradigm in the provision of rehabilitation towards the public.

2. To create a Rehabilitation Center that will offer accessible services for the province’s locals

3. To improve the physical and social function of the disabled.

4. To improve data system in correlation to the disabilities within the province.

1.5. Scope and Limitations

1.5.1 Scope

The proposed project will follow the objectives of the proposed ordinance of the Philippine

Academy Rehabilitation Medicine for the country to have a Rehabilitation Center for each

city/town. The project will include a Rehabilitation center for both out-patient and in-

patient users as well as its amenities (not finalized). The center will try to preserve the

natural views and features of the area. Aside from the Rehabilitation center, the project will

provide a research facility to the further study (in the terms of gathering and analyzing

statistics) of the current state of disability within the province.

1.5.1 Limitations

Due to different reasons, the proponent will not be able to attain some information. The

following are the unavoidable limitations of this study:

• The proposed project will only provide a rehabilitation center in a specific city

• The proposed project will not by any means function as an all-in-one solution for

the demand of Physical rehabilitation

• It is a prevalent problem that limited data in Disabilities and its correlation of

rehabilitation is available

• The proposed project will mostly use technology and services commonly found

and supported in the Philippines. This does not include technologies or

innovations that can be deemed feasible by the researcher

References:

Health Grove, Musculoskeletal Disorders in the Philippines

http://global-disease-burden.healthgrove.com/l/75694/Musculoskeletal-Disorders-in-Philippines,
Philippine Statistics Authority, Safety and Health in The Workplace Cases of Occupational
Diseases
https://psa.gov.ph/sites/default/files/vol19_19.pdf
International classification of functioning, disability and health (ICF). Geneva: World
Health Organization; 2001.
http://www.who.int/classification/icf/en/
Disasters, disability and rehabilitation. Geneva: World Health Organization Department of
Injuries and Violence Prevention.
http://www.who.int/violence_injury_prevention/other_injury/disaster_disability2.pdf
World Disaster Report 2007 2007.
http://www.ifrc.org/PageFiles/99876/2007/WDR2007-English.pdf
Risk factors to musculoskeletal disorders and anthropometric measurements of Filipino
manufacturing workers.
https://www.ncbi.nlm.nih.gov/pubmed/15598359

Musculoskeletal pain and dysfunction among University of the Philippines Manila

personnel.

http://www.herdin.ph/index.php/component/herdin/?view=research&cid=38768#physiLoc
Musculoskeletal conditions
https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions
Poverty Reduction for The Disabled in The Philippines
https://disability-studies.leeds.ac.uk/wp-content/uploads/sites/40/library/mori-JRP151-Philippine-
PWD-Livelihood.pdf