TimeThe best therapeutic window is within three months of injury. Immediately after injury, the spinal cord goes through a shock period in which a cascade of events occur, including bleeding or ischemia, edema, and spontaneous lysis. The damage will gradually spread up and down the cord. Early intervention of ZSA (even day one) helps to control bleeding and edema, shorten the spinal shock period, and, consequently, minimize neurological damage.
If ZSA is initiated after three months, functional recovery accrues more slowly and at a lesser magnitude. It requires many times the effort to produce a fraction of the same result as in the first month.

DaoyinA vigorous, persistent, six-to-eight hour/day exercise regimen is recommended, including passive and active movements, breathing, and relaxation. Even when active motion is not visible, the patient’s intention or mental visualization is crucial. There is nothing mystical about using the mind. Basically, the brain initiates nerve signals to travel down the spinal cord, making attempts to find new neuronal pathways through the injury site. Once a visible movement is detected, the patient is asked to repeat the same pattern over and over to establish nervous-system memory. Our neural circuits turn off when they are not used, and, therefore, must be re-learned. By repetition, muscle strength increases and atrophy reverses.

Zhu encourages patients to use a standing frame early on, believing that standing has many benefits, including keeping the spine straight, preventing scoliosis, pressure sores, and bone loss; and improving pulmonary and cardiac functions.

Scalp acupunctureMany patients are discouraged by the slow progress they make following standard rehabilitation programs. The addition of ZSA to such programs accelerates progress. Zhu expresses this recovery process through an analogy: “patients with SCI are like people trapped inside a dark room. Those who stay motionless will remain in the room forever. Those who exercise are probing for an exit, but the door is closed. Scalp acupuncture acts like a key. It opens the door and allows light to shine through. However, the person still needs to move towards the door, and lift his legs over the threshold in order to step out into the sun. Otherwise, he is still confined in the room no matter how wide the door is opened.”