Afinalproposal

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE
A PROPOSED HYDROTHERAPY AND PHYSICAL

REHABILITATION CENTER FOR IN LAGUNA CITY
A Thesis Proposal Presented to the

College of Architecture
Adamson University
In Partial Fulfillment
Of the Requirements of the Degree
Bachelor of Science in Architecture
By
Niel Montealegre Mirambil
May 17, 2015

PAGE
ACKNOWLEDGEMENT
Foremost, I would like to express my sincere gratitude to
my advisor Arch. Jasmine Lee for her continuous support of my
bachelor study and research, for her patience, motivation,
enthusiasm, and immense knowledge. Her guidance helped me
in all the time of research and writing of this thesis. I could not
have imagined having a better advisor and mentor for my
bachelor study.
I thank my precious friends in Adamson University: Tyrone
R. Lopez, Anna Robelle C. Bandalaria, Blessa M. Montullo, Joanna
Marie Cabanilla, Yzara Cloie Mariano, Don McJohn Padilla, Cyril
Magrampa, and Gino Henry A. Ogaco, for helping me gathered
data, for their never-ending encouragement, and for all the fun
and unforgettable memories we have had in the last four years.
I would like to thank my family: my parents Nonito J.
Mirambil and Lucylyn M. Mirambil, for giving birth to me at the
first place and supporting me spiritually throughout my life.
Last but not the least, I would like to thank God for giving
me the knowledge and wisdom and allowing me to able to share
this gifts to my fellow researchers and readers. To God be always
the glory.

PAGE
ABSTRACT
The proposed hydrotherapy and physical rehabilitation
center aids the needs of people by offering quality and relevant
therapy and treatment for their recovery. The increasing number
of persons with disability have pursue the researcher to design
for a rehabilitation center. Persons with disability, if not helped
there is a possibility that theyll be a problem to the society.
Theyre deficiency is not a hindrance for them to succeed in life
like normal people do. The approach in dealing with this study is
through interviews, survey, and through gathering of data.
Architectural Accessibility for the Disabled and articles from
Ministry Of Social Services And Development are few of the
literature to be use by the researcher in his study. The study is
expected to run for 1 month. The researcher therefore concluded
that establishing a physical rehabilitation center would be
efficient to aid the need.
Keywords:
hydrotherapy,
rehabilitation, disability
physical
rehabilitation,

PAGE
TABLE OF CONTENTS
ACKNOWLEDGEMENT
ABSTRACT
TABLE OF CONTENTS
LIST OF TABLES
LIST OF FIGURES
LIST OF GRAPHS
THE INTRODUCTION
1.1.
1.2.
1.3.
1.4.
1.5.
1.6.
1.7.
BACKGROUND OF THE STUDY

STATEMENT OF THE PROBLEM
OBJECTIVES OF THE STUDY
SIGNIFICANCE OF THE STUDY
CONCEPTUAL FRAMEWORK
PROJECT SCOPE & LIMITATIONS
DEFINITION OF TERMS
THE LITERATURE REVIEW

2.1.
REVIEW OF THE LITERATURE
2.2.
CASE STUDIES
2.2.1 Rehabilitation in Ghana
a. General background on Ghana
b. Disability and rehabilitation in Ghana
c.
Cultural attitudes towards disability in Ghana
d.
Plans for the future of rehabilitation in Ghana
2.2.2 Physical and rehabilitation medicine training

center in Split, Croatia
a. History of rehabilitation medicine in Croatia
b. Current status of rehabilitation medicine in
Croatia
c.
Development of PRM training center in Split,
Croatia
2.3.
RESEARCH PARADIGM
2.4.
SYNTHESIS
THE RESEARCH METHOD
3.1.
3.2.
RESEARCH DESIGN
DATA GATHERING

PAGE
3.3.
DATA PROCESSING
REFERENCES
APPENDIX
APPENDIX
APPENDIX
APPENDIX
APPENDIX
1:
2:
3:
4:
5:
39
APPENDIX 6:
40
SURVEY
INTERVIEW QUESTIONS
INTERVIEW REQUEST LETTER
CASE STUDY (MIND MAP)
TIMETABLE FOR RESEARCH
ABOUT THE AUTHOR
BUDGETARY REQUIREMENTS

PAGE
LIST OF TABLES
NO TABLE OF FIGURES ENTRIES FOUND.
LIST OF FIGURE

PAGE
Figure 1: Approximate patient costs of othotics devices in Ghana

(2005).
21
Figure 2: Graphical presentation of the nine most common
reasons for hospitalization at the Department of Physical
Medicine, Rehabilitation and
24

PAGE
LIST OF GRAPHS
NO TABLE OF FIGURES ENTRIES FOUND.
10

PAGE
CHAPTER 1
THE INTRODUCTION
Whatever
maybe
our
predicament
in
the
present
conditions in every aspects of living, it is perhaps important to

give dully attention to each member of the society. Each member
of the society, the strong ones or the needy always strive to
mold an image for everyone to see. Some are being challenged
by their difficulties and they are the physically disabled ones.
Disabled persons shares the same right and the same role
as any other persons do in our society. Own to be able to
maximize their own potential must be able to perform their
obligations accordingly. It is obviously difficult for the disabled to
their part if we arent able to provide the aid they needed in
order to function well. Through this proposal the researcher sees
would be of greater help for the disabled ones to showcase their
maximum potentials.
Physical rehabilitation is the active process by which those
disabled by injury or diseases work with specialists towards full
recovery or if a full recovery is not possible, to an optimal
physical, mental and social state. Through exercise and physical
activity, patients are re-taught basic movement functions until
proven fit to cope on their own. The main objective of this

PAGE
therapy is for the patient to eventually be re-integrated into
society. (Gadamer, 1996) Rehabilitation centers are institutions
supported by the whole society to train, to develop, and to
rehabilitate the working capacity of a disabled persons. The
increasing number of population of disabled person have
persuade the researcher to conduct this study and came up to
propose for a physical rehabilitation center. The idea of proposing
for a rehabilitation center is to help the disabled persons be
rehabilitated
from
both
their
medical
and
vocational
in
capabilities.
1.1.
BACKGROUND OF THE STUDY
Based upon reading historical details, the governments

began their concerns for the disabled persons as early as 1917.
Republic Act 7277 of 19922 or the Magna Carta for Disabled
Persons is the principal policy document for Filipinos with
Disabilities.
(Historical
Background,
2016)
Self-sufficiency
services that teach independence and incorporation into the

majority of the society and offering persons with disability
rehabilitation is the primary aim of the Magna Carta for the
Disabled Persons. (Arroyo, 2008) It includes the previous Batas
Pambansa 344 of 19833 or the Accessibility Law through a
provision.
(Historical Background, 2016) Putting facilities and

PAGE
other devices that enhance the mobility of disabled on all
buildings, institutions, establishments and public utilities is as
required by The Batas Pambansa Blg 334 or better known as the
Accessibility Law. (Marcos, 1983)
Philippines facilitated the Second International Conference
on
Legislation
Concerning
the
Disabled
prepared
by
the
Rehabilitation Internationals national affiliate and the Philippine

Foundation for the Rehabilitation of Disabled Persons (PFRD) on
the year 1978 of January 16-20. The National Commission
Concerning Disabled Persons (NCCDP) was formed by the signing
of P.D. No. 1509 by the late President Marcos forming. A longterm National Rehabilitation Plan (NRP) was organized and
implemented by the NCCDP. The Philippine Foundation for the
Rehabilitation of Disabled, Inc. (PFRD) inaugurated in 1978,
functioned as the Commissions Secretariat to support the
NCCDP Board in the implementation of its goals and purposes.
(Historical Background, 2016)
This agreement stayed in effect until P.D. 1509 was
modified
by
P.D.
1761
on
January
4,
1981.
During
the
International Year of Disabled Persons on December 17, 1981,

the NDDC declare the Decade of Disabled Persons (1981-1991)
as a nationwide adherence. (Historical Background, 2016)

PAGE
The National Observance in the Philippines of the Asian
and Pacific Decade of Disabled Persons affirmed during 19932002 by Proclamation No. 125 under Fidel V. Ramos. On this
decade,
the
distribution
of
information,
coordination,
and
observing of programs, projects and activities regarding concerns

on disability are applied by both the private and public sectors.
(Ramos, 1993)
In 2006, Republic Act 94424 modified RA 7277, by adding
social and economic requirements like the 20% discount on
buying
of
medicine
and
daily
essentials
as
well
as
transportations and recreational services. The redefinition of the

functions and organizational structure of the National Council for
the Welfare of the Disabled Persons (NCWDP) and renamed the
agency as the National Council on Disability Affairs (NCDA) was
stated during the announcement of Presidential Order No. 709 in
26 of February 2008. The Department of Social Welfare and
Development (DSWD) was ordered by the Office of the President
under Gloria Macapagal-Arroyo to hand over the NCDA in order to
fortify the governments programs for the welfare of the persons
with disabilities.(Historical Background, 2016)

PAGE
1.2.
STATEMENT OF THE PROBLEM
The main problem of the study was to be able to design an
efficient rehabilitation center that will cater the needs of disabled
persons. The plan of the rehabilitation center adopts in the needs
of the users where in it must be flexible.
The environment within most rehabilitation centers seldom
causes unpleasing and traumatic experience not only for the
patients but also to the medical and administrative personnel
who are working to facilitate the need of the patients.
Therefore, the study prioritize in tackling on the following
fields of the to come upon the possible solutions for the proposal.
This following fields are the following:
1. The Specific Use of the Project.
2. The Activities within the Space.
3. The Required Space and Allocation for Every Activity.
4. The Legal Consideration (Local/National/International)
Concerning the Design and Construction of a Rehabilitation
Center.
5. The Impact of the Project to the Environment.
1.3.
OBJECTIVES OF THE STUDY
The study seeks to be able to design a modern and

sustainable physical rehabilitation spaces and facilities providing

PAGE
ideas and solutions to problems that the existing rehabilitation
centers experiences and to provide physical medical services
especially in Laguna City.
1.3.1. In achieving these goals following the standards set
by the Department of Health. Other foreign studies are also use
by the researcher as an additional reference in designing and
constructing
the
proposed
hydrotherapy
and
physical
rehabilitation center.
1.3.2. The proposed physical rehabilitation center should
also take into account the number of projected years for the
hospital to meet propose solution. The number of projected
population of users is to be taken into consideration to be able to
foresee the accommodation of growing demand.
1.3.3. Most importantly, the researcher prioritize the
physical rehabilitation centers influence to its environment. The
existing condition of the environment is taken into consideration
in the designing and construction.
The researcher aims to
provide a design that will cater the needs of the users without
harming the surrounding existing environment.
1.4.
SIGNIFICANCE OF THE STUDY
The rehabilitation center will be offering of great assistance

to the disabled persons. The student, professionals, and layman

PAGE
who reads this book may find this study significant due to the
fact that it address to the development of the disabled persons.
Moreover, the researcher also consider the following to be
the beneficiaries of the proposal:
1.4.1. Students
Gaining the knowledge about physical rehabilitation
centers, its purpose and the people it serves. There is
a change perspective about disabled persons in
capabilities. This study serves as guide for students in
their ways of formulating their design solutions for
physical rehabilitation given the existing status of the
countrys healthcare system with regards to people
with disabilities.
1.4.2. Organizations
Different organization with concerns about aiding
physical health
government or private is inform
about proposals vision of designing a facility that

caters the need of physically disabled persons.
Through this proposal there are inform about the
needs for this facilities to maximize the disableds full
potential for the development of the country. Their

PAGE
respond to this proposal can greatly affect the
development of future rehabilitation centers.
1.4.3. Professionals
The study shall facilitate the work of planners,
architect, and designers, who are engaged in the
public and private buildings in their region by making
this book a source of knowledge regarding barrier free
design, the physical rehabilitation center as their
reference.
1.4.4. Environment
The environment as the primary consideration in the
proposal is also its primary beneficiary.
1.4.5. Future Researchers
This proposal will influence and guide the thinking of
the
future
researches
on
how
to
treat
the
environment by designing a sustainable and less

waste producing hospital.
This study expects to develop the type of rehabilitation
center which provides opportunity to the disabled persons to be
a part of the society.
This study can be an inspiration to anybody who are
socially involved in the development of the society.

PAGE
1.5.
CONCEPTUAL FRAMEWORK
The researcher have analyzes and summarizes key notes
and major considerations to be seen in related literature that
Proce
serves Inpu
as a guide to support the
possible solution for
the stated
Outp
ss
t
ut
problems (See 1.2. Statement of the Problem). These problems
is simplified to generalized ideas through the conceptual
framework states the possible processes in formulating the
solutions for these problems.
Landscapes
Sustainable
Design
Green
Innovation
Connection with
the Environment
Energy-Cost
Reduction
Comfort
Improve Human
Health
Facilities
Improve users
well -being
Eco therapy
Training
Enhance Human
mobility
Treatment
PWD Friendly
facilities
Improve users
performance

PAGE
Therapeutic Landscapes in a Healthcare environments

were proven before to be successful in increasing the capability
of the said environment to promote healthcare. (Gesler, 1993)
Furthermore, exercise interventions decrease psychological
and physiological disease- and treatment-specific side effects,
such as fatigue, depression, lymphedema, and incontinence,
leading to an increased quality of life during and after therapy.
(Zimmer, et al., 2016)
Furthermore, moderate walking done regularly has been
proven to enhance mood, as well as boost the bodys immune
system. (Strenberg, 2009)
In order to create a healing spaces within physical
rehabilitation environments, architects must first have a general
understanding
therapies
of
physical
involved.
This
rehabilitation
will
allow
and
the
architects
to
strategic
design
appropriate spaces that accommodate the required spatial needs

of physical therapists and their patients. Through the theories of

PAGE
creating healing places, architects can implement design
decisions that target positive emotional responses. (Losier, 2015)
1.6.
PROJECT SCOPE & LIMITATIONS
1.6.1. Project Scope

This
study
will
focus
solely
in
the
analysis
and
determination the physical needs of the disabled persons. The

study will also covered the legal considerations regarding
building a rehabilitation center. The proposal will apply the
concepts of Holistic Approach to Space Design, Eco-Therapy as a
Fortification to Healthcare Design, and Therapeutic Environment
as Healing Design.
Trauma, one problem related to rehabilitation, has been
studied somewhat and provides some insight into the difficulty in
providing rehabilitation care. (Tinney, Chiodo, Haig, & Wiredu,
2007)
Eco-therapy is a diverse term that incorporates techniques
and practices that promotes sustainable healing between all the
aspects of a human and its natural world where it evolves.
(Chalquist, 2009)
Therapeutic Landscapes in a Healthcare environments
were proven before to be successful in increasing the capability
of the said environment to promote healthcare. (Gesler, 1993)

PAGE
New Trends that currently well used in sustainable and
modern hospitals are used namely, Eco-effective design and
evidence-based design.
These trends are practical in terms of
promoting healthcare with respect to its surrounding healing

environment, thus what must be considered most is how it would
be maintained to achieve sustainable design. (Shepley, Baum,
Ginsberg, & Rostenberg, 2009)
1.6.2. Limitations
However due to time constraint, the following are not to be
undertaken thoroughly by the researcher.
Furthermore, the
researcher might not be able to provide data such as maps,

graphs and statistic and other informative data that will be
needing much time in data gathering. Also the study will not be
able to cover possible solutions such as the plans, elevations,
sections, perspective and other utilities.
1.7.
DEFINITION OF TERMS
1. Ambiance the type of atmosphere that a space or
place affects the feeling of a user.
2. Aesthetics deals with the beauty and the pleasing
perception of the eye
3. Barrier- Free- it means no restriction; hindrances.

PAGE
4. Brise-soleil - reduces heat, and dominates the faade
while creating shadows.
5. Diverse state of having difference or variety.
6. Eco-therapy a state where in the human is being
healed
by
its
environment
as
how
it
heals
sustainably.
7. Green design (building) - aims for the ultimate good
of the environment.
8. Disability- A restriction or inability to perform an
activity in the manner or within the range considered
normal for a human being, mostly resulting from
impairment.
9. Hydrotherapy-
an
alternative
medicine
which
includes the use of water for pain relief and

treatments.
10.
Marquise-
connects
from
one
building
to
another; a path walk.

11.
NCCDP-
National
Commission
Concerning
Disabled Persons.
12.
NRP -National Rehabilitation Plan.
13.
PFRD-Philippine
Foundation
Rehabilitation for Disabled Persons.
for
the

PAGE
14.
Physical Rehabilitation- medical specialty which
can help people regain body functions they lost due
to medical conditions or injury.
15.
Physical Therapy- the treatment of disease,
injury, or deformity by physical methods such as

massage, heat treatment, and exercise rather than
by drugs or surgery.
16.
PWD- Person with Disability.
17.
Rehabilitation- act of restoring something to its
original state.
18.
Sustainability - the state of being ecologically
balanced from the present to the future generations.

19.
Sustainable architecture - the materials, space
and energy that shall be consumed in building

structure shall be minimize to lessen the impact to
the environment.
20.
Therapeutic a way to describe a subject as a
healing of illness.

PAGE
CHAPTER 2
THE LITERATURE REVIEW
This chapter consists all the materials such as journals and
books used to gather related studies from both local and foreign.
These chapter aims to link the current and existing knowledge
and status of hospitals that would relate to this proposal.
2.1.
REVIEW OF THE LITERATURE
Almost 600 million out of the more than 6 billion people in

the world are experiencing some kind of disability. 80% of the
worlds disabled population lives in low economic countries.
Unfortunately, only 1 2% of the disabled receives rehabilitative
services in the developing world as reported by the World Health
Organization (WHO). It is evident in many countries that there is
a lack of medical rehabilitation. (Tinney, Chiodo, Haig, & Wiredu,
2007)
The International Classification of Functioning, Disability
and Health (ICF) refers to disability as an umbrella term
covering impairments, activity limitations, and participation
restrictions. An impairment is a problem in body function or
structure; an activity limitation is a difficulty encountered by an
individual in executing a task or action; while a participation

PAGE
restriction is a problem experienced by an individual in
involvement in life situations. The ICFs definition of disability
denotes a negative interaction between a person (with a health
condition) and his or her contextual factors (environmental and
personal factors). A comprehensive approach in interventions is
then necessary for persons with disabilities (PWDs) as it entails
actions beyond the context of health, but more on helping them
to overcome difficulties by removing environmental and social
barriers. (WHO, 2013)
Globally, over 1 billion people, or approximately 15% of the
worlds population, have some form of disability. About 110 to
190 million people 15 years and older have significant difficulties
in functioning. Moreover, the rapid spread of chronic diseases
and population ageing contribute to the increasing rates of
disability. About 80% of the worlds PWDs live in low-income
countries, wherein majority are poor and cannot access basic
services. With their conditions, PWDs need greater attention and
considerations in terms of health needs, without discrimination.
However, reports show that PWDs have less access to health
services and therefore have greater unmet needs. (WHO, 2012)
In the Philippines, the results of the 2010 Census of
Population and Housing (CPH, 2010) show that of the household

PAGE
population of 92.1 million, 1.443 million Filipinos or 1.57%, have
a disability. Region IV-A, with 193 thousand PWDs, was recorded
to have the highest number of PWD among the 17 regions, while
the Cordillera Administrative Region (CAR) had the lowest
number with 26 thousand PWDs. There were more males, who
accounted for 50.9% of the total PWD in 2010, compared to
females, with 49.1% with disability. For every five (5) PWD, one
(18.9%) was aged 0 to 14 years, three (59.0%) were in the
working age group (15-64 years old), and one (22.1%) was aged
65 years and above. (NSO, 2013)
To enhances and restores functional ability and quality of
life of those with physical impairments or disabilities are the
primary
aims
of
Rehabilitation
medicine.
Through
interdisciplinary team approach it is best accomplished, its one

of the hallmarks of rehabilitation medicine. Since the population
is
ageing,
especially
the
frequency
diseases
of
the
of
non-communicable
musculoskeletal
diseases
system
and
neurological ailments is rising, as well as the number of road

traffic polytrauma, it is generally agreed that there must be an
rise of the needs for medical rehabilitation.(Vlak, et al., 2013)
The second largest city in Croatia which is Split is located
on the Adriatic coast. 1700 years ago it was founded by the

PAGE
Roman Emperor Diocletian for treatment of diseases and
implementation of rehabilitation procedures in a place where the
sulfurous water springs offered the possibility. According to
legends, the Emperor Diocletian undergoes treatment the reason
why the Diocletian palace was built precisely on the location
where there was exceptionally rich sulfurous water springs. (Vlak,
et al., 2013)
In prevention and rehabilitation of cancer, the importance
of exercise programs as part of supportive therapies in the past
decades. Regular exercise and physical activity reduce cancer
risk and mortality as showed results from epidemiological
studies.
Furthermore,
exercise
interventions
decrease
psychological and physiological disease- and treatment-specific

side effects, such as fatigue, depression, lymphedema, and
incontinence, leading to an increased quality of life during and
after therapy. (Zimmer, et al., 2016)
In
relation
to
the
importance
of
exercise,
walking,
especially for older citizens, is known to improve cardiovascular

health and muscle strength. (Kerr, Rosenberg, & Frank, 2012)
Furthermore, moderate walking done regularly has been proven
to enhance mood, as well as boost the bodys immune system.
(Strenberg, 2009) As explained by Esther Sternberg in Healing

PAGE
Spaces, walking can be meditative: you focus your attention on
the rhythm and speed of your breathing during every bodily
movement: and it becomes a soothing ritual, where each step is
an effective way to manage stress. (Strenberg, 2009) An
example of therapeutic walking includes labyrinths, which
involves walking as stress relief within a manicured setting. Once
popular in many European gardens, labyrinths are now often
included in health care designs. Using many features of Tai-Chi, a
system
of
exercises
practiced
for
health
and
relaxation,
labyrinths encourage physiological relaxation through controlled

breathing. (Strenberg, 2009) What should be noted from
therapeutic walking is that it combines the design of healing
spaces with the benefits of physical activity. Natural settings,
fresh air and daylight surround the walking path, which creates
an environment rich in calming, sensorial elements that permit
mental relaxation for those experiencing stressful situations. If
applied correctly to the circulation system of a building, this
spatial intervention and form of exercise could be used not only
by patients, but also by staff members and visitors as a
therapeutic way-finding tool around the facility. (Losier, 2015)
Hospital design is infamously known for its confusing
spatial organization, disorienting hallways and poorly-explained

PAGE
layout. Patients and visitors constantly find themselves getting
lost when navigating the corridors of hospital facilities. If we are
to encourage these environments to be interactive, dynamic and
social places, a proper configuration and system must be
designed. Wayfinding is a technique that uses the physical
environment to navigate from one location to another. (Eberhard,
2009) This is because when walking, our brains perceive objects
and then place them in sequences, forming a memory of the
places we experience as a result. (Strenberg, 2009) Connecting
these familiar sights forms a mental map and people become
acquainted with the area more easily. One technique use wayfinding within a predefine environment, like a rehabilitation
center, to position specific markers or colors on pathways,
thereby creating visual markers as memory aids that lead to a
specific end or destination. In addition, placing an object entices
curiosity of the mind and encourages our bodies to move
towards
it.
(Strenberg, 2009)
Using this
strategy, spatial
organization becomes a discovery, seducing human movement

rather than directing it. (Zumthor, 2006) If these objects or
markers incorporate vegetation, specific materials or other
spatial healing components, such as large windows which
provide orienting views to the exterior, the wayfinding can

PAGE
essentially become a therapeutic tool. These strategies can offer
patients and visitors an enjoyable procession through health
facilities, making unfamiliar aspects of health centers more
comforting. It is important to note that including elements for
those with disabilities is essential because a rehabilitation center
caters to a variety of people, thus it should be inclusive. Visual,
spatial, auditory, textural and proprioceptive cues, signals that
occur when moving through space, are various ways to enhance
the use of a patients way-finding abilities. (Strenberg, 2009)
Over time and with practice, repetition and graphic markers,
spaces become more familiar and way-finding becomes easier.
As explained by John Eberhard in Brain Landscape: motor skills
are embedded in procedures which are expressed through
performance. (Eberhard, 2009) This illustrates that the more
one practices and repeats a movement, the better it will be
expressed over time. For that reason, way-finding can be a
playful device that engages users to move and explore their
building. (Losier, 2015)

PAGE
2.2.
CASE STUDIES
2.2.1
REHABILITATION
IN
THE PHILIPPINES
Physical therapy in the Philippines developed as a vocation
through three important stages in Philippine history, from the
American period to the Japanese occupation of the country
during World War II, and up today during the period of the
Philippines
Republics
independence.
Physical
therapy
has
familiarized in the Philippines before rehabilitation treatment

came. (Mangusan, 2012)
AMERICAN ERA
University of Santo Tomas
During this era, physical therapy training in the Philippines
began when the Faculty of Medicine and Surgery of the
University of Santo Tomas under the presidency of Dr. Bonito
Valdes established the Sector of Electrotherapeutics during
school year of 1908-1909. The syllabus used by the Faculty of
Medicine and Surgery at the University of Santo Tomas during
1916 includes teaching of physiotherapy alongside teaching of
radiography. (History of PT in the Philippines, 2013)

PAGE
2.2.2
REHABILITATION
IN
GHANA
a. GENERAL BACKGROUND ON GHANA
Ghana is a country on the west equatorial coast of Africa.
The country has a recent stable political history compared to its
neighbors. However, with only 13 years of democracy, foreign
investment in the country is just beginning. Prior military rule has
resulted in a pervasive passive attitude amongst many people,
although entrepreneurial ship is on the rise. Its population of 20
million has an average income of $300 (U.S.). The top industry is
agriculture with cocoa beans as the primary crop. (Tinney,
Chiodo, Haig, & Wiredu, 2007)
b. DISABILITY AND REHABILITATION IN GHANA
Ghana
has
over
one
million
people
with
disability.
Approximately 95% of the disabled population has no access to

rehabilitation services. Although there are many causes for
disability in Ghana, there is little information published in the
medical literature. In 2000, 49% of non-fatal traumatic injuries in
Ghana received no formal medical care. Of those who received
some type of care, only 20% received care at a hospital. (Mock,
Ofusu, & Gish, 2001) Training for the management of injuries
along with rehabilitation of these injuries has received little

PAGE
formal attention, perhaps because of the cost of care. Mock and
colleagues state:
Labor at the Ghanaian minimum wage equivalent to US $1
per day, the disability time incurred by the injured person alone
would be considered higher economic value than the money
spent on treatment, especially in rural areas. (Mock, Gloyd,
Adjei, Acheampong, & Gish, 2003)
There are no inpatient rehabilitation facilities in the country.
There are also no physical medicine and rehabilitation physicians
in Ghana. Only one retired occupational therapist and one
speech-language pathologist could be identified in the capital
city. The approximately 20 30 physical therapists in the country
were mostly trained in Eastern Europe, around the time of the
Cold War. On the average they have less than 10 years of service
left before mandatory retirement at age 60. (Tinney, Chiodo,
Haig, & Wiredu, 2007)
c. CULTURAL ATTITUDES TOWARDS DISABILITY IN
GHANA
Traditional beliefs have a large influence on attitudes
toward the disabled in Ghana. Illness and disability are often
conceptualized as being the result of evil

PAGE
influences or of failure to keep taboos. Traditional religious beliefs
in Ghana have played a role in alienating and suppressing people
with disabilities, and in the past, to the extreme of even killing
them. Earlier studies have indicated disabled persons and their
families did not patronize rehabilitation services due to the
stigma that comes with disability in Ghana, the majority of which
live in rural areas, where the stigma of disability may be more
pronounced. In one study, it was observed that disabled persons
would instead drift to urban areas to beg for food and money,
rather than seek rehabilitation. (Tinney, Chiodo, Haig, & Wiredu,
2007)
Figure 1: Approximate patient costs of orthotics devices

in Ghana (2005).

PAGE
d. PLANS FOR THE FUTURE OF REHABILITATION IN
GHANA
A huge step in the development of medical rehabilitation
services was the establishment of the School of Allied Health
Sciences at the University of Ghana. The Ministry of Health
initially asked the Ministry of Education to develop an allied
health professional program. One of the first programs to be
started was the physiotherapy training program. They are set to
graduate the first class of physiotherapists in 2006. There have
been several visiting faculty from other parts of Africa, but a
major concern for the future of the physiotherapy program is
obtaining and retaining faculty. The School of Allied Health
Sciences has yet to include other rehabilitation training programs
in occupational therapy, speech therapy and orthotics and
prosthetics, although there are continued hopes to establish
these programs in the future. (Tinney, Chiodo, Haig, & Wiredu,
2007)

PAGE
2.2.3 PHYSICAL AND REHABILITATION MEDICINE
TRAINING CENTER IN SPLIT, CROATIA
a. HISTORY
OF
REHABILITATION
MEDICINE
IN
CROATIA
There is a small country in the Central Eastern Europe
namely Croatia, it has the 100-year-old tradition in rehabilitation
medicine. Thermal resorts were the first rehabilitation facilities in
Croatia established to utilized mineral springs. It traditionally
used in the historical region of Croatia since the Roman time for
healing purposes. The richness of mineral springs all over Croatia
led
to
development
rehabilitation
centers.
of
large
number
of
The
poor
consistency
specialized
of
health
professionals and deficiency of a common vision
of the
development of rehabilitation medicine as a profession was

largely contributed by the geographical distribution of these
institutions.(Vlak, et al., 2013)
b. CURRENT STATUS OF REHABILITATION MEDICINE
IN CROATIA
There is a high ratio of 0.42 per 1000 inhabitants where in
there are 1900 rehabilitation beds in Croatia, considering that
the minimum recommended standard is 0.10. The second
highest ratio of physical and rehabilitation medicine (PRM) is in

PAGE
Croatia where there are 100 000 inhabitants among European
Union of Medical Specialists (UEMS) member countries per
specialists. There is 1:3000 ratio of physiotherapists inhabitants
is
considerably
Switzerland,
lesser
Austria,
than
or
the
equivalent
Slovenia.
proportion
Other
in
rehabilitation
professionals is unequally low in number. These professionals

who are play a significant part in rehabilitation group are the
psychologists,
social
workers,
occupational
and
speech
therapists, nurses and others.(Vlak, et al., 2013)

Although
some
of
these
numbers
are
impressive,
rehabilitation medicine in Croatia did not yet reach necessary

standards. Rehabilitation medicine in Croatia needs to address
many issues, such as increasing rehabilitation needs, abundance
of
PRM
specialists
and
rehabilitation
beds,
as
well
as
shortcomings in education, which is focused on rheumatology

rather than rehabilitation. The existing traditional system of
rehabilitation care cannot satisfy the new standards set for
quality and efficiency of rehabilitation medicine. (Vlak, et al.,
2013)

PAGE
c. DEVELOPMENT OF PRM TRAINING CENTER IN
SPLIT, CROATIA
Split is the second largest city in Croatia, located on the
Adriatic coast. It was founded 1700 years ago by the Roman
Emperor Diocletian at the place where the sulfurous water
springs offered the possibility for treatment of diseases and
implementation of rehabilitation procedures. The legend tells
that the Diocletian palace was built precisely on the location that
was exceptionally rich in sulfurous water springs, for treatment of
the Emperor Diocletian. Nowadays, Split is a university city,
offering a respectable university education for different profiles
of medical professionals, where new PRM training center has
been developed. (Vlak, et al., 2013)

PAGE
Figure 2: Graphical presentation of the nine most

common reasons for hospitalization at the Department of
Physical Medicine, Rehabilitation
2.3.
RESEARCH PARADIGM
DYNAMIC THERAPY SPACES

The first dynamic therapy spaces main objective is to
gently re-introduce patients to movement and, as such, is
intended for those with extreme mobile difficulty. In recognition
of these difficulties, this space is conveniently located near the
patient rooms which reduces issues with distance and travel
while providing them with easy access to physical therapy and
the roof terrace. (Losier, 2015)
The first dynamic therapy space focuses on giving patients
a zone for walking with adequate assistance while infusing the
space with healing qualities such as views to the exterior, natural

PAGE
ventilation, daylight and appropriate materials. In order to allow
physical therapy to occur slowly, a walking harness track enables
patients to walk throughout the space and circulate across the
floor. By incorporating this device into the circulation spaces,
patients are able to experience more of the building as they
gradually improve their gait, thus granting them a more scenic
and sensorial environment than being contained within a room.
The track itself is embedded in the ceiling as to make it less
obvious to the eye and obstructive to the ceilings appearance,
with only the harness straps being visible as the patients moves.
As patients are led through the first dynamic space, they are able
to enjoy floor to ceiling views of the roof gardens. (Losier, 2015)
CROSS-SHAPED SCHEME
An architecture firm in Brazil, ALTA was appointed with the
development of the IPA Methodist University central campus in
Porto Alegre. The proposal asked for the adding of a new physical
rehabilitation center that rejoices the practice of the organization
in physiotherapy teachings and physical education. The structure
should include sports and therapeutic services along with room
for faculty members. The proposal suggests adding of a small
tower of offices and laboratories for researchers that pairs with
the deans existing stone building, and a dominating truss-based

PAGE
volume for the sports facilities, suitable for the demands of the
city. (Azerado, 2015)
A central campus plaza to welcome and orient the visitors
via a marquise that connects the old buildings with the entrance
of the new one is what a cross shaped scheme means. The
truss-based structure which is shows a contemporary design,
features a brise-soleil that reduces heat, and dominates the
faade while creating shadows that play with the interiors main
gallery. The pool areas and multi-sports courts have a windows
form floor to ceiling which has an easing panoramic views of the
city. The land was selected by taking advantage of the sloping
ground in the southeastern part which is utilized in creating
space to build several parking levels and minimizing the ground
handling costs. The proposals results to a campus designed
especially
for
people
with
disabilities
with
the
laws
of
accessibility applied throughout the scheme. (Azerado, 2015)

2.4.
SYNTHESIS
Trauma within the space is one problem related to

rehabilitation design. A great effort has to be exerted to study
this concern and provide somewhat some insight about possible
solutions for this problem. I would like to promote a medical

PAGE
spaces that will give a whole lot experience not only for patients,
visitors and also for administrative and health personnel.
Eco-therapy is a modern trend that should be taken into
consideration for according to studies that seeing green in
medical spaces helps in improving the health conditions of
patients. Incorporating landscaping into spaces gives a lot of
benefits not only to patients but to all the users. Also landscaping
is a characteristic incorporated by designers, architects and
professionals when it comes to sustainable designs of medical
spaces and other structures.
Exercise is essential to be incorporated to the improvement
of the patients. While finding their way to the space patients are
required to make their way to exercise their injuries. Walking with
adequate assistance while incorporating into the space with
healing
qualities
such
as
views
to
the
exterior,
natural
ventilation, daylight and some appropriate materials. A walking

harness track is provided to enable the patients to walk
throughout the space and circulate across the floor. Through
walking the patients can experience more of the building while
improving their walk.
Hydrotherapic medical approach also have its potentials in
accordance to its geographical location. Laguna being known for

PAGE
its hot springs offers a great potentials for the proposal.
Hydrotherapy have been use roman emperors in their relaxation
while now it has been discover of its health benefits.
CHAPTER 3
THE RESEARCH METHOD
In this chapter the procedures and development that the
researcher have undertaken to arrive in the goals and objectives
of the proposal. The data gathered, evidences and guide use by
the researcher to reach the proposals objectives shall be
discussed in detailed and be covered in this chapter.
3.1. RESEARCH DESIGN
The be able to inform the readers about the researchers
vision about the proposal, the researchers needs to consider not
only his own point of view but he must involve his readers or a
certain population in concern with the said study. Conducting
certain methodology in data gathering are being made by the
researcher to help him in his undertakings, this kind of data
gathering is called a qualitative type of research. It also involves
the actual procedures in sustaining the existing relationship and
development between these perspectives, as well as how are
these perspectives being pictured through their physical, social
and cultural background.

PAGE
Meanwhile, other mathematical related exemplary and
hypotheses developed to relate to a phenomena is called a
quantitative design type of research.
It provides the central
connection between experimental observation and mathematical

expression of communication.
The proposal data gathering aims to inform the researcher
about the current perception of the selected population to be
involved
with
the
study
with
regards
to
the
effects
of
rehabilitation center to their environment as well as how do

patients are treated in the facility, the quality of service they
offer, the possible recommendation to improve the patients
experience and to improve health recovery. It shall also prove
that the data discussed from the previous chapter shows
relationship of the ideas cited by the researcher and the results
of the data gathering. It gives the conclusion of the possible
development of a hydrotherapy and physical rehabilitation center
with modernize facilities and some developments to the existing
environment.
3.2. DATA GATHERING
A survey will be disseminated to the choose population to
aid the researcher in his undertakings, it concerns the localities
that will come up to an answer based upon their perceptions

PAGE
about the proposals. Which is also been questioned based on
their scope of knowledge within their territory. Factors such as
the environment, healthcare, location and everyday experiences
with their local medical facilities have been prioritize in the
formulation of the questions that were necessary in determining
the conditions of the concerned area.
The survey contains a grading scale of 1 to 5 with 5 being
the highest. The survey also contain questions to be answered
by
the
respondents.
The
researcher
also
provided
recommendation field to accommodate any suggestions of the

respondents.
3.2.1. Interview Protocol
The researcher will foremost discuss and inform the
respondents about the nature and significance of the research
wherein they are going to be a huge part of. (See Appendix 1)
Conducting an intensive separate interviews with a small
number of informants to explore their perceptions on the
particular idea, proposals, or condition is involved in the
application of the in-depth interview method to gather data from
the informants. (Boyce and Neale, 2016)

PAGE
3.3. DATA PROCESSING
The researcher highlights both the positive and negative
aspects of different evaluation and legislative systems to meet
the strategies that is necessary for the needs of the proposal.
(Capolongo, 2015).
Generalizing research objectives which starts from a
sample to a larger scope of population is the major purpose of
research. Making assumptions is proficient by using analytical
methods on contingency theory, which means that a sample is
only a part of the population selected to be the scope related to
the project which will fairly represent the whole population of the
concerned population. Evidently, studies that only uses samples
will be less expensive and more possible than study of the entire
population, which means the goal of the sampling is that the
small part of population being studied must reflect on the whole
population without errors. (Suresh, 2011)
The population to be covered by the researcher is a
selected number of population of Laguna city because of the
time constrain and the dense of the population. The researcher
focuses on a small population but analyzed the characteristic of
the population to be covered.
3.4.

PAGE
REFERENCES
Arroyo, G. M. (2008). Magna Carta for Disabled Persons,and for
other Purposes. Manila: House of Representatives.
Azerado, G. (2015, 9 26). Designboom. Retrieved from ALTA:
http://www.designboom.com/architecture/alta-rehabilitationcentre-brazil-09-26-2015/
Chalquist, C. (2009, August 1). Retrieved from Ecopsychology:
http://online.liebertpub.com/doi/abs/10.1089/eco.2009.0003
Eberhard, J. P. (2009). Brain Landscape the Coexistence of
Neuroscience and Architecture. Oxford: Oxford UP.
Gadamer, H.-G. (1996). The Enigma of Health: The Art of Healing
in a Scientific Age. Stanford: Stanford UP.
Gesler, W. M. (1993). Therapeutic landscapes: theory and a case
study of epidauros, greece. Environment and Planning D:
Society and Space, 171-189.
Historical Background. (2016, May 11). Retrieved from National
Council
on
Disability
Affairs:
http://www.ncda.gov.ph/about/historical-background/
Kerr, J., Rosenberg, D., & Frank, L. (2012). The Role of the Built
Environment in Healthy Aging: Community Design, Physical

PAGE
Activity, and Health among Older Adults.. Journal of Planning
Literature, 43-60.
Losier, O. F. (2015). Architectural Physiotheraphy: A Dynamic
Healing Process. Ontario: Carleton University.
Marcos, F. (1983). Batas Pambansa Blg. 344. Manila: Batasang
Pambansa.
Ramos, F. V. (1993). Proclamation No. 125. Manila City: Batasang
Pambansa.
Shepley, M. M., Baum, M., Ginsberg, R., & Rostenberg, B. (2009).
Eco-Effective Design and Evidence-Based Design: Perceived
Synergy and Conflict. HERD: Health Environments Research &
Design Journal, 56-70.
Strenberg, E. M. (2009). Healing Spaces: The Science of Place
and Well-being. Cambridge: Ma:Belknap of Harvard UP.
Tinney, M., Chiodo, A., Haig, A., & Wiredu, E. (2007). Introduction.
Medical Rehabilitation in Ghana, 921- 927.
Vlak, T., Soso, D., Becir, B., Marinovic, I., Pivalica, D., Tukic, A., . . .
Jericevic, S. P. (2013). Physical and rehabilitation medicine
training center in Split, Croatia:. Disability and Rehabilitation,
782-786.
Zimmer, P., Baumann, F. T., Oberste, M., Wright, P., Garthe, A.,
Schenk, A., . . . Wolf, F. (2016). Effects of Exercise

PAGE
Interventions and Physical Activity Behavior. BioMed Research
International, 13.
ENDICES

PAGE
APPENDIX 1:
SURVEY

PAGE
Appendix 2: INTERVIEW QUESTIONS
1) Are you aware of hydrotherapy as a methodology in
treating physical injuries and other medical cases?
(Yes or No)
2) How well do you see your medical buildings in terms
of maintenance? Do you think your municipality is in
need of a physical rehabilitation center?
3) How satisfied are you with their facilities and
services?
4) Do you think your medical structures such as a
physical rehabilitation center positively affects it
surrounding environment?
5) Do you think it supports pro-life techniques which
would contribute good effects to future users?
6) Do you see your medical buildings such as a physical
rehabilitation center as a big contributor to your local
waste and pollution?
7) If a proposed local physical rehabilitation center with
hydrotherapy is to be build, will you go or not? If not,
please justify.
8) Do you agree that a physical rehabilitation center is
possible to be developed by your local government?

PAGE
9) How much do you agree that a physical rehabilitation
center with a hydrotherapy will help boost the
patients healthcare?
10)
Do you think your municipality is in need of
physical rehabilitation center?

Appendix 3: INTERVIEW REQUEST LETTER
May 2016
To whom it may concern,
Greetings!
In partial fulfillment of the requirements for Research

Methods, I, Niel M. Mirambil is currently undergoing a research
study
entitled,
PROPOSED
HYRDOTHERAPY
AND
PHYSICAL REHABILITATION CENTER IN LAGUNA CITY. In

this regard, may I ask some of your time to answer a few
questions that may benefit the development of the project
proposal. Your knowledge with relation to this topic will be an
essential contribution to this endeavor. The information provided
will be a substantial addition to the said proposal, and with my
best effort, use the information gathered to provide awareness
and contribution to the development of the country.

PAGE
Thank you very much.
Respectfully yours,
Niel M. Mirambil

PAGE
Appendix 4: CASE STUDY (MIND MAP)

PAGE

PAGE
APPENDIX 5:
TIMETABLE FOR RESEARCH
A. First Semester
ACTIVITIES
>Choosing a topic
Title Defense
Part 1: Introduction to thesis
a. Submission/Consultation >Proposed thesis
Chapter 1: >Project Objectives
>Introduction
>Background and Nature of the Study
>Statement of the Problem
>Significance of the Project
c. Review of Related Literature
d. Submission of final draft of Part 1 Chapter 1
Part 2: Chapter 1
a. Submission/Consultation >Project Scope of Work
>Site Criteria and Description
>Proposed thesis outline
>Proposed time frame and schedule
>Tentative Bibliography
APRIL
2
3
MAY
2
3

PAGE
>Tentative Appendices
b. Site Investigation
>Preliminary Interview
c. Gathering of Preliminary Data (Maps and Demographies)
d. Investigation of rehabilitation programs
f. Further researches/submission/consultation of:
>Review of Related Literature
>Site Criteria and Description
>S.W.O.T. Analysis of the Site
g. Revision of chapter 1 &2
i. Submission of Volume 1, Part 1: Chapter 1&2
Chapter 3: Methodology
Part 1: Chapter 4 Project Profile and Analysis
a. Site Investigation > Maps and other related materials
b. Interview with the locals
> History of the Place
> Case Studies and Investigation
> Legal Issues (rules, regulations, building programs and
government codes)
c. Submission/Consultation of chapter3
d. Further reserches and interviews
e. Finalized SWOT Analysis
Appendix 6:
BUDGETARY REQUIREMENTS
SOURCES OF EXPENSES
Quantit
y
TRAVEL TO SITE
PROCESSING OF LEGAL DOCUMENTS
PRINTING OF SURVEY FORMS
PRINTING OF BOOK ( 1ST DRAFT)
PRINTING OF BOOK (FINAL DRAFT)
INK (BLACK & COLORED FOR
PRINTING)
LAPTOP
BOOKBINDING (SOFTBIND FOR 1ST
DRAFT)
BOOKBINDING (HARBIND FOR FINAL
DRAFT)
SKETCHPAD
Total
Amount
(PhP)
500.00
600.00
200.00
450.00
600.00
2,000.00
69,000.0
0
150.00
300.00
150.00
73950.0
0

PAGE
ABOUT THE AUTHOR
NIEL MONTEALEGRE MIRAMBIL

Email
Address:
n.mirambil03@gmail.com
Contact
Information:
09051023034
4th
year
student
of
Adamson
University, College of Architecture. Living the dream to be a

licensed and professional Architect.
I came from a small town
within the heart of National Capital Region, Pateros, known for its
famous exotic and delicious street food, the Balut. The thing
about architecture that interest me is how architecture creates
innovations which copes in the evolving needs of the society
without harming the environment.

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ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

A PROPOSED HYDROTHERAPY AND PHYSICAL

A Thesis Proposal Presented to the

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

BACKGROUND OF THE STUDY

THE LITERATURE REVIEW

Plans for the future of rehabilitation in Ghana

2.2.2 Physical and rehabilitation medicine training

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

ABOUT THE AUTHOR

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

Figure 1: Approximate patient costs of othotics devices in Ghana

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

conditions in every aspects of living, it is perhaps important to

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

BACKGROUND OF THE STUDY

Based upon reading historical details, the governments

services that teach independence and incorporation into the

(Historical Background, 2016) Putting facilities and

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

Rehabilitation Internationals national affiliate and the Philippine

International Year of Disabled Persons on December 17, 1981,

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

observing of programs, projects and activities regarding concerns

transportations and recreational services. The redefinition of the

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

OBJECTIVES OF THE STUDY

The study seeks to be able to design a modern and

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

The researcher aims to

SIGNIFICANCE OF THE STUDY

The rehabilitation center will be offering of great assistance

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

government or private is inform

about proposals vision of designing a facility that

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

environment by designing a sustainable and less

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

Therapeutic Landscapes in a Healthcare environments

appropriate spaces that accommodate the required spatial needs

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

PROJECT SCOPE & LIMITATIONS

1.6.1. Project Scope

determination the physical needs of the disabled persons. The

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

These trends are practical in terms of

promoting healthcare with respect to its surrounding healing

researcher might not be able to provide data such as maps,

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

includes the use of water for pain relief and

another; a path walk.

NRP -National Rehabilitation Plan.

Rehabilitation for Disabled Persons.

ADAMSON UNIVERSITY COLLEGE OF ARCHITECTURE

Physical Therapy- the treatment of disease,

injury, or deformity by physical methods such as

PWD- Person with Disability.

Rehabilitation- act of restoring something to its