Assessment of RSL sculpting in rehabilitation of patients with motor disorders

The goal of rehabilitation of patients with motor impairments — improvement of their motor and psychological functions —can be achieved by RSL sculpting procedure.

Medical rehabilitation is currently defined as “a complex of medical and psychological measures aimed at full or partial restoration of disturbed functions and (or) compensation of lost functions of the affected organ or system of the organism, preservation of restored functions of the organism after completion of acutely developed or exacerbation of chronic pathological process in the organism”^1,2.

Unlike the former classical doctrines based mainly on wait-and-see tactics and symptomatic therapy, nowadays a proactive approach prevails. It calls for preventive rehabilitation using such methods as:

• early use of rehabilitation programs aiming at muscle strength development and increase of motion range of the affected extremity (forced use principle) in patients after stroke^3-6;
• massage for treatment of children with cerebral palsy in the early period of their life to prevent contracture formation, metabolic stasis, normalize nervous system operation, reduce pathologic reflexes.

Different massage methods belong to the existing rehabilitation methods. They are not used as the main ones, however, they are the most affordable and easy, and thus also important for rehabilitation. Manual massage is significantly less effective than mechanical massage techniques as it cannot guarantee deep tissue treatment, an even and deep pressure and has a demerit related to “human factor” as people can get tired. RSL sculpting procedure performed using Beautylizer is one of the most advanced, effective, and safe procedures of mechanical massage. High efficiency and safety of this method have been proved by multiple studies^7-11.

The procedure is based on the vibration and compression effect of spheres on all skin layers, hypodermis, as well as muscles. The cylindrical handpiece consists of 72 simultaneously rotating spheres made of FDA12 compliant hypoallergenic medical grade silicone. The spheres are arranged in the form of a honeycomb. Their rotation creates a wave acting like a lymph pump. The spheres can rotate in 4 modes than can be changed using the handpiece handle. Even if the rotation speed is high, the spheres do not pinch patient’s skin thus effectively negating any unpleasant consequences such as hematomas. Moreover, the technology ensures vibration that together with compression significantly improves blood and lymph flow thus boosting tissue blood and nerve supply and oxygen supply.

Frequency of microvibrations, roller’s rpm and direction are adjustable. For example, roller torque can reach 450 rpm, and the roller can rotate in both directions.

Intellectual control system can identify tissue density and calculate, with high degree of accuracy, the force to be applied. The software has three pressure options for the handpiece: high, medium, and low pressure. If the pressure within one pressure level changes, it will be indicated on the LED scale. Vibration and pressure depend on sphere diameter (20 mm) and distance between spheres (0.368 mm). These are the only conditions under which the required vibration amplitude with the guaranteed result can be generated. Rigidity of the spheres is also important. If they are too soft, they will not generate vibration; if they are too firm, their vibration may cause damage. There are two types of spheres of different rigidity (70 and 80 Shore) that can be used with the Beautylizer device¹².

Due to the above-described mechanisms, the following effects are achieved in tissues:

• Vasodilating effect: compression and subsequent recovery of tissue volume due to its elastic properties provide vasodilation and a significant increase in microcirculation;
• Draining effect: rhythmic pulsation stimulates lymph flow, facilitating the removal of excess fluid;
• Relaxing effect: the device has a stretching effect on muscles, effectively relieving muscle spasms;
• Analgesic effect: exposure of the skin mechanoreceptors to vibration can significantly reduce intensity of pain;
• Improvement of skin mechanical properties: LED therapy can optimize the tissue healing process and stimulate cell turnover; it stimulates production of TGF-β by fibroblasts, which leads to the increased density of collagen and elastin fibers^13-16.

RSL sculpting has a complex positive effect on the body by leveraging on reflex, neurohumoral, and metabolic processes regulated by the central nervous system⁶. The initial step in mechanism of massage using RSL sculpting is mechanical irritation of numerous and various skin receptors, muscles, tendons, ligaments, and vessel walls. The flow of nerve impulses arising from irritation of these receptors enters the central nervous system along sensitive nerve fibers, where a generalized complex reaction of the body is formed and manifested in the form of functional shifts in various organs and systems. The nature of the body response will depend on the functional status of the higher parts of the central nervous system and the functional status of the receptive field being treated¹⁷.

Humoral factor plays a key role in the mechanism of RSL sculpting. It was demonstrated that histamine, heparin, acetylcholine, and other biologically active substances that cause certain effects are activated and released from cells under mechanical stimulation on tissues. In particular, histamine dilates capillaries, activates local and systemic blood flow thus increasing skin temperature and promoting red coloration in the massage treatment area. Heparin thins the blood and improves blood supply to all body parts, regardless of treatment spot. Acetylcholine performs a mediator function and increases the rate of nervous impulse transmission from nerve cells to skeletal muscle cells, which has a positive effect on muscle activity¹⁸.

Direct mechanical effect of the RSL sculpting on the human body helps increase blood flow and lymphokinesis, decongest, increase the temperature of the massaged body area, and trigger metabolic processes¹⁷. Under the influence of RSL sculpting, the temperature of the massaged body area increases, which helps accelerate metabolic processes; skin hyperemia occurs, corneocytes (dead, terminally differentiated keratinocytes) are removed, the excretory function of the sebaceous and sweat glands involved in the process of heat transfer is stimulated; the functioning capillaries expand and the reserve capillaries open, the work of the heart is facilitated, the contractility of the myocardium increases, the outflow of venous blood and lymph increases, congestion in both circles of blood circulation decreases, and the absorption of oxygen by tissues improves; the flow of oxygen and nutrients to the tissues of the massaged area increases thus accelerating removal of metabolic products, including lactic acid; muscle elasticity, contractility, strength, and performance improve, muscle fatigue decreases, the speed of recovery of muscles after physical work increases; muscle atrophy decelerates^17-20.

Advantages of the procedure include its physiological nature, good compatibility with the other therapeutic agents, and possibility of using the physical factors in various therapeutic regimens, its painlessness, and lack of toxicity and allergic reactions^7-17.

A number of studies and clinical observations that proved safety and effectiveness of the RSL sculpting procedure both as a monoprocedure and as a part of a complex therapy together with other techniques used for aesthetical purposes were performed in the “Linline” clinic network^10,11,21-24.

Although the procedure is very safe there is a number of contraindications that shall be considered^25-29:

• general critical condition;
• body temperature above 38°C;
• sepsis suspected;
• history of malignant tumor or their current presence;
• mental disorders;
• active tuberculosis;
• use of cardiac pacemaker;
• cardiovascular insufficiency, pulmonary insufficiency, renal failure;
• bleedings;
• thrombophlebitis.

The goal of rehabilitation of patients with motor impairments is the improvement of motor and psychological functions, improvement of self-care and social adaptation capabilities.

Listed below are some expected results of RSL sculpting as a part of integrated rehabilitation in patients with motor disorders:

1. Reduction of the severity of spasticity of limb muscles;
2. Formation of a new movement pattern;
3. Improvement of movement and blood and nerve supply functions, and consequently;
4. Social adaptation.