{
  "resourceType": "ActivityDefinition",
  "id": "box-breathing",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/box-breathing",
  "version": "1",
  "name": "BoxBreathing",
  "title": "Box Breathing (4-4-4-4)",
  "status": "draft",
  "experimental": true,
  "description": "Equal-ratio breathing: 4 s inhale → 4 s hold → 4 s exhale → 4 s hold. Repeat. Useful for acute anxiety reduction and attention regulation.",
  "useContext": [
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "user"
      },
      "valueCodeableConcept": {
        "text": "difficulty: beginner"
      }
    }
  ],
  "topic": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "box-breathing",
          "display": "Box Breathing (4-4-4-4)"
        }
      ]
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "1 minute minimum (effective); 5–10 min for sustained effect."
    }
  ],
  "usage": "Evidence: moderate.",
  "note": [
    {
      "text": "Count silently to 4 on each phase — pace through the nose where comfortable"
    },
    {
      "text": "Holds should be relaxed, not strained. Drop to 3-3-3-3 if 4-4-4-4 feels effortful"
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Diaphragm"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "5798000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "External Intercostals"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "53967007"
          }
        }
      ]
    }
  ]
}