feasibility study musculoskeletal wellness center
TRANSCRIPT
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CHAPTER I
EXECUTIVE SUMMARY
Introduction:
The human musculoskeletal system (also known as the locomotor system)
is an organ systemthat gives humans(and many animalspecies) 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 tissuethat 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 calciumandphosphorusand 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 diagnosedue 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.
http://en.wikipedia.org/wiki/Organ_(anatomy)http://en.wikipedia.org/wiki/Humanhttp://en.wikipedia.org/wiki/Animalhttp://en.wikipedia.org/wiki/Muscular_systemhttp://en.wikipedia.org/wiki/Skeletal_systemhttp://en.wikipedia.org/wiki/Skeletonhttp://en.wikipedia.org/wiki/Musclehttp://en.wikipedia.org/wiki/Cartilagehttp://en.wikipedia.org/wiki/Tendonshttp://en.wikipedia.org/wiki/Ligamentshttp://en.wikipedia.org/wiki/Jointshttp://en.wikipedia.org/wiki/Connective_tissuehttp://en.wikipedia.org/wiki/Calciumhttp://en.wikipedia.org/wiki/Phosphorushttp://en.wikipedia.org/wiki/Hematopoietic_systemhttp://en.wikipedia.org/wiki/Medical_diagnosishttp://en.wikipedia.org/wiki/Physiatristhttp://en.wikipedia.org/wiki/Physical_Medicine_and_Rehabilitationhttp://en.wikipedia.org/wiki/Physical_Medicine_and_Rehabilitationhttp://en.wikipedia.org/wiki/Orthopaedic_surgeonhttp://en.wikipedia.org/wiki/Organ_(anatomy)http://en.wikipedia.org/wiki/Humanhttp://en.wikipedia.org/wiki/Animalhttp://en.wikipedia.org/wiki/Muscular_systemhttp://en.wikipedia.org/wiki/Skeletal_systemhttp://en.wikipedia.org/wiki/Skeletonhttp://en.wikipedia.org/wiki/Musclehttp://en.wikipedia.org/wiki/Cartilagehttp://en.wikipedia.org/wiki/Tendonshttp://en.wikipedia.org/wiki/Ligamentshttp://en.wikipedia.org/wiki/Jointshttp://en.wikipedia.org/wiki/Connective_tissuehttp://en.wikipedia.org/wiki/Calciumhttp://en.wikipedia.org/wiki/Phosphorushttp://en.wikipedia.org/wiki/Hematopoietic_systemhttp://en.wikipedia.org/wiki/Medical_diagnosishttp://en.wikipedia.org/wiki/Physiatristhttp://en.wikipedia.org/wiki/Physical_Medicine_and_Rehabilitationhttp://en.wikipedia.org/wiki/Physical_Medicine_and_Rehabilitationhttp://en.wikipedia.org/wiki/Orthopaedic_surgeon -
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'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
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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.
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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 (85) and accredited by the "hilippine 5ealth Insurance
orporation ("hil5ealth) as . #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@
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utologous 7tem ell Therapy
nesthesiology
haplaincy? 5ealth Cducation
hemotherapy
8ental 7ervices
8iagnostic Imaging
T% 7can
8 Ccho
*8 Bltrasound
D% $ay
8ialysis
8ietary? anteen? 5ealth 3oods
Clectrocardiogram (CE)
0 5ours Cmergency 7ervices
Cndoscopy
#edicine
Internal #edicine
ardiology
8ermatology
8iabetology
CCFT
Cndocrinology
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Eastroenterology
Eeriatric #edicine
5ematology
#edical ncology
"ulmonology
"sychiatry
'aboratory
Glood Gank
E2"8 onfirmatory Testing
Fewborn 7creening
Gacteriology
7pecial Tests
bstetrics and Eynecology
b%gyne
Eyne ncology
"ediatric and dolescent
Eynecology
"athology
"ediatrics
Eeneral "ediatrics
"ediatric 5ematology
"ediatric ncology
"ediatric ardiology
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0 5our "harmacy
"hysical Therapy
7urgery
Eeneral 7urgery
CCFT
CFT% 5ead and Feck 7urgery
Feuro 7urgery
phthalmology
rthopedic
Brology
7moking essation "rogram
Greast 3eeding ampaign
Furse Training "rograms
ritical are Fursing
I: Therapy Fursing
ther 7pecialty reas ($, 58B, C$)
Santiago Cit
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fficial 7eal
Countr "hilippines
Region agayan :alley ($egion II)
Pro!ince Isabela
"i#trict (0th 8istrict of Isabela and
7antiago ity)
$ounded #ay A-A
Cithood Huly 2, 110
Baranga# */
%o!ern&ent
' Maor Hoseph 7alvador Tan
Area
' Tota( /-.;; km(;2.A s9 mi)
Po)u(ation (;;)
' Tota( *,A;0
' "en#it 0A;?km(,*;;?s9 mi)
Ti&e *one "5T(BTA)
+IP Code **
Inco&e
c(a##
st class 6 independent component
city
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Hi#tor
The origin of 7antiago ity can be drawn from the first native settlement
discovered by the early 7panish missionaries at the bank of the old arig $iver
(now 8iadi $iver) from which its original name, arig, was derived. The early
inhabitants were the Eaddangs and the Ibanags. 4hen the 7panishsettled in,
the city was named "ueblo of 7antiago postol de arig, with7antiagoas the
7panish name of 7aint Hames the postle. In the early 1-;s, the #unicipal
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"resident :icente arreon changed the name to simply 7antiago. 7antiago
remained a municipalityfor A0 years.
7antiago was originally a part of the province agayan(comprising the
whole agayan :alleyregion), which was reorgani&ed as a political subdivision
in -A* with Fueva 7egovia as its capital. n #ay , A-2, when
the "rovinceof 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
intended for 7antiago and other towns, owing to its pro!imity to the agayan
$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 :alleyand 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.
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In 10-, founded to the liberation in the town of 7antiago province
of Isabelabeginning the 3ilipino soldiers of the st, nd, th, th, *th and
-th Infantry 8ivision and the B73I"%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 ourtcontested 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
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omponent ity in $egion II, most of the establishments seen in #anila can also
be found here.
The ity of 7antiago is an independentcitylocated in
Forthern 'u&onisland 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, Isabelaand =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 agayan :alley,
surrounded by the araballo #ountainsto the south, the Ereat 7ierra #adreto
the east and the ordillera #ountain $ange to the west.
7antiago ityis 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 orporationhas recently launched $obinsons "lace
7antiago as its pioneer mall in agayan :alley. :ista 'and and 'ifescapes,
Inc.entered agayan :alley by building amella Isabela. It has recently
launched another project named as amella 7antiago. The head%office of Erupo
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#arilens, the largest homegrown corporation in the region, is in 7antiago ity.
Three of the biggest T: networks in the country (i.e.G7%
GF, E#/,T:-)stationed their regional networks in the city. 7an #iguel
orp., "epsi ola, "urefoods,8igiteland"'8Talso 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
uthoritycompetes with local traders to stabili&e prices.
7antiago ityhouses 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
:alley 7anitarium are also e9ually e9uipped private hospitals. The 7antiago ity
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 ollege, one of the oldest schools in the region. The
7outhern Isabela ollege of rts and Trades is the biggest vocational school
operating in the city.
%eogra)h
http://en.wikipedia.org/w/index.php?title=Grupo_Marilens&action=edit&redlink=1http://en.wikipedia.org/wiki/ABS-CBNhttp://en.wikipedia.org/wiki/ABS-CBNhttp://en.wikipedia.org/wiki/GMA_Networkhttp://en.wikipedia.org/wiki/TV5_(Philippines)http://en.wikipedia.org/wiki/San_Miguel_Corphttp://en.wikipedia.org/wiki/San_Miguel_Corphttp://en.wikipedia.org/wiki/Pepsihttp://en.wikipedia.org/w/index.php?title=Purefoods&action=edit&redlink=1http://en.wikipedia.org/wiki/Digital_Telecommunications_Phils.,_Inc.http://en.wikipedia.org/wiki/PLDThttp://en.wikipedia.org/wiki/Mitsubishihttp://en.wikipedia.org/wiki/Nissanhttp://en.wikipedia.org/wiki/Isuzuhttp://en.wikipedia.org/wiki/Hyundaihttp://en.wikipedia.org/wiki/Kia_Motorshttp://en.wikipedia.org/wiki/Fordhttp://en.wikipedia.org/wiki/National_Food_Authorityhttp://en.wikipedia.org/wiki/National_Food_Authorityhttps://www.facebook.com/SantiagoCityPhil.3311http://en.wikipedia.org/w/index.php?title=Grupo_Marilens&action=edit&redlink=1http://en.wikipedia.org/wiki/ABS-CBNhttp://en.wikipedia.org/wiki/ABS-CBNhttp://en.wikipedia.org/wiki/GMA_Networkhttp://en.wikipedia.org/wiki/TV5_(Philippines)http://en.wikipedia.org/wiki/San_Miguel_Corphttp://en.wikipedia.org/wiki/San_Miguel_Corphttp://en.wikipedia.org/wiki/Pepsihttp://en.wikipedia.org/w/index.php?title=Purefoods&action=edit&redlink=1http://en.wikipedia.org/wiki/Digital_Telecommunications_Phils.,_Inc.http://en.wikipedia.org/wiki/PLDThttp://en.wikipedia.org/wiki/Mitsubishihttp://en.wikipedia.org/wiki/Nissanhttp://en.wikipedia.org/wiki/Isuzuhttp://en.wikipedia.org/wiki/Hyundaihttp://en.wikipedia.org/wiki/Kia_Motorshttp://en.wikipedia.org/wiki/Fordhttp://en.wikipedia.org/wiki/National_Food_Authorityhttp://en.wikipedia.org/wiki/National_Food_Authorityhttps://www.facebook.com/SantiagoCityPhil.3311 -
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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#
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7antiago ity is politically subdivided into */ barangays.
bra
mbalatungan
Galintocatoc
Galuarte
Gannawag Forte
Gatal
Guenavista (Brban)
abulay
alao Cast ("ob.)
alao 4est ("ob.)
alaocan (Brban)
:illa Eon&aga
entro Cast ("ob.)
entro 4est
("ob.)
8ivisoria
8ubinan Cast
("ob.)
8ubinan 4est
(Brban)
'una
#abini ("ob.)
#alvar ("ob.)
Fabbuan
Faggasican
"atul
"laridel (Brban)
$i&al (Brban)
$osario (Brban)
7agana
7alvador
7an ndres (Brban)
7an Isidro
7an Hose
7inili
7insayon (Brban)
7anta $osa
:ictory Forte ("ob.)
:ictory 7ur (Brban)
:illasis ("ob.)
"e&ogra)hic#
Po)u(ation Cen#u# of Santiago Cit
Year Po), -. ),a,
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/001 1A,-0 N
2333 ;,-* .*+
2334 2,00 .1+23/3 *,A;0 ./;+
%o!ern&ent
The city is governed by a mayor%councilsystem. There are ; ity
ouncilors. The council is the official government body of the city, it is also
known as 7FEBFIFE "FE'BFE78. 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 ity farmers per cropping,
and is e!pected to bring 7antiago 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(#
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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. eline baya%
7i9uian
oun. "andong 'ugod
oun. :inchy ggabao
oun. ysen #arrero
oun. Kathrina 7able
oun. Ficky Gautista
oun. 5e! lvare&
oun. ndong 8irige
oun. Grenda $agsac%
'una
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 Festivalor dubbed as Santiago Day.
"attaradday is an Ibanagword 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 systemthat gives humans(and
many animalspecies) the ability to move using the muscularandskeletal
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
http://en.wikipedia.org/wiki/Organ_(anatomy)http://en.wikipedia.org/wiki/Humanhttp://en.wikipedia.org/wiki/Animalhttp://en.wikipedia.org/wiki/Muscular_systemhttp://en.wikipedia.org/wiki/Skeletal_systemhttp://en.wikipedia.org/wiki/Skeletal_systemhttp://en.wikipedia.org/wiki/Organ_(anatomy)http://en.wikipedia.org/wiki/Humanhttp://en.wikipedia.org/wiki/Animalhttp://en.wikipedia.org/wiki/Muscular_systemhttp://en.wikipedia.org/wiki/Skeletal_systemhttp://en.wikipedia.org/wiki/Skeletal_system -
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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.
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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@
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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
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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 stimulationhas been found to be
ineffective for lower back pain,however, it might help withdiabetic neuropathy.
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Tran#cutaneou# e(ectrica( ner!e #ti&u(ation 8TE7S9is 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.
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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,
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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#:
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. 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.
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rgani*ationa( Chart:
CHAPTER