Case Report: C6 ASIA B SCI
About these Case Reports
One of the most rewarding parts of teaching the Foundations course is seeing how quickly clinicians begin integrating the concepts into their own practice.
This Clinical Case blog series shares case reports submitted by clinicians who completed the 3-day Foundations Course and applied the material with their clients the very next week.
These examples highlight not only the clinicians’ growing confidence and clinical reasoning, but also how approachable and immediately applicable the system can be. Each case offers a glimpse into real-world implementation—showing how small shifts in observation, cueing, and exercise selection can lead to meaningful changes in movement and function.
Tell me a little about your client:
Neuro diagnosis, level of injury, time since injury onset, goals
Diagnosis: SCI C6 ASIA B
Time since Injury: 46 years post
History of: shoulder arthritis, bicep tears, rotator cuff tears
Goals:
Maintain independent transfers
Driving
What have you been working on in clinic together?
What kind of exercises, areas, skills…
Shoulder range of motion
Reducing shoulder pain
Shoulder strengthening using light DB & bands
Lower limb spasticity management
Posture (reduce tightness of C-shaped scoliosis to right)
Photo from 3-Day Course in San Diego - March 2025
What new things did you try this week with your client?
Or how did your program/coaching style/exercise selection change based on what you learned in the course?
I have always focussed my exercise prescription on gross motor movement, so honing in on more specific areas of connection was new to me.
3D thorax set-up was very successful.
What verbal and/or kinesthetic cues (set-ups, props, discussions) helped your client tap into something new or more specific?
“Scoop” & “corkscrew” cues for serratus activation were game-changers.
Paired with kinesthetic cueing on shoulder to limit the 'shoulder hike'.
»He reported feeling his pec relax throughout the movement.
What functional or subjective outcomes came as a result of the new program?
He reported no shoulder pain in his transfers this week!
“My arms feel fatigued, but there is no pain. I have not felt fatigue in my arms for months, I usually have to stop due to pain"
How was the experience for you?
Easier and more intuitive.
The framework and drills progression helped give me a clear direction for my exercise prescription. I usually prescribed large gross motor skills and provide assistance to make each task achievable.
In this session, we focused on the nuanced movements to help my client find strength and stability in his shoulder without pain! + less assistance from myself through the movements.
Anything else to add?
This week, my goal is to add the ZN approach to every session, even in a small aspect of the session. Looking at the nuanced movement tasks in the set-ups you taught, I am able to easily identify weakness/tightness/laxity in the chain and more intuitively guide my clients through tasks to improve this.
I have been using the approach with SCI, MS and ALS all have reported some benefits!
Thank you, Alex for submitting your case!
Learn more / work with Alex here.
Interested in getting these results from SIMPLE interventions?
Join us for the next course!
In-depth look and exploration of the ZN Framework for Recovery: a system for building neurological connection and full-body integration, from the ground up. Following the properties of fascial tensegrity, individuals with SCI can access “paralyzed areas” to become more competent in foundational movement patterns, such as rolling over, transitioning to sitting and getting into quadruped. This course follows the ‘typical’ progression for those with C5-T12 SCI, along with mention of other neuro diagnosis, through applied systems of the Motor Development Progression and Pilates principles.
