ABSTRACT
BACKGROUND: Muscle-based perception of the spatial properties of limbs constrains the patterning, timing and magnitude of muscle forces while performing motor activities. The centrality of muscle-based perception to both ordinary and skilled actions warrants attention from the rehabilitation community, since deficits in its functioning would be related to important functional limitations. In this overview, we summarize a body of research that may be used to guide the development of effective assessment tools and rehabilitation programs that are specifically directed towards such deficits. OBJECTIVES: There were four specific aims: first, to present an information-based approach to muscle-based perception that is grounded in physical laws; second to identify central principles underlying muscle-based perception that have been revealed and supported by empirical work; third, to summarize reports that have investigated whether the principles identified can be generalized to muscle-based perception in individuals with sensory-motor impairments; and fourth to provide a preliminary discussion of the potential implications of the research presented here for issues relating to rehabilitation.
INTRODUÇÃO: A percepção muscular das propriedades espaciais dos membros restringe o padrão, período e magnitude das forças exercidas durante a execução de atividades motoras. A importância central da percepção muscular, tanto para ações rotineiras quanto para ações especializadas, merece atenção da comunidade envolvida na área de reabilitação, uma vez que alterações em suas funções podem estar relacionadas a importantes limitações funcionais. Nesta revisão, os autores apresentam um resumo da pesquisa que pode ser utilizada para guiar o desenvolvimento de ferramentas de avaliação eficazes bem como programas de reabilitação que sejam especificamente direcionados para estas disfunções. OBJETIVOS: Quatro pontos específicos foram incluídos: primeiro, a apresentação da abordagem com base em informações relativas à percepção muscular de acordo com as leis da física; segundo, a identificação dos princípios centrais determinantes da percepção muscular que vem sendo revelada e apoiada por trabalhos empíricos; terceiro, um resumo dos relatos que investigaram e se os princípios identificados poderiam ser generalizados para a percepção muscular dos indivíduos com alterações motoras e sensitivas; e quarto, uma discussão preliminar sobre as implicações potenciais da pesquisa aqui apresentada, no tocante aos assuntos relacionados à reabilitação.
ABSTRACT
Echinococcus granulosus remains a clinical problem in sheep and subsistence farming communities in South Africa. The most commonly affected organs are the liver and the lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. Clinical examination is unreliable in making the diagnosis. Serological testing has a broad range of sensitivity and specificity and is dependent on the purity of the antigens utilised. Ultrasound examination of the abdomen is both sensitive and cost effective. Computed tomography and endoscopic retrograde cholangiopancreatography (ERCP) are reserved for complicated cases. The differential diagnosis includes any cystic lesion of the liver. Liver hydatid cysts can be treated by medical or minimally invasive (laparoscopic and percutaneous) means or by conventional open surgery. The most effective chemotherapeutic agents against the parasite are the benzimidazole carbamates; albendazole and mebendazole. Albendazole is more efficacious; but recommended treatment regimens differ widely in terms of timing; length of treatment and dose. Medical treatment alone is not an effective and durable treatment option. PAIR (puncture; aspiration; injection; reaspiration) is the newest and most widely practised minimally invasive technique with encouraging results; but it requires considerable expertise. Open surgery remains the most accessible and widely practised method of treatment in South Africa. The options are either radical (pericystectomy and hepatic resection) or conservative (deroofing and management of the residual cavity). Various scolicidal agents are used intraoperatively (Eusol; hypertonic saline and others); although none have been tested in a formal randomised controlled trial. Laparoscopic surgery trials are small and unconvincing at present and should be limited to centres with expertise. Complicated cysts (intrabiliary rupture and secondary infection) may require ERCP to obtain biliary clearance before surgery; and referral to a specialist centre may be indicated