{
  "resourceType": "ActivityDefinition",
  "id": "calf-stretch",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/calf-stretch",
  "version": "1",
  "name": "CalfStretch",
  "title": "Calf Stretch (Wall Stretch)",
  "status": "draft",
  "experimental": true,
  "description": "Standing stretch for the gastrocnemius and soleus. Patient places hands on wall with one foot forward and one back, leaning into the wall.",
  "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": "calf-stretch",
          "display": "Calf Stretch (Wall Stretch)"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "ankle",
          "display": "Ankle"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "70258002",
          "display": "Structure of ankle joint"
        }
      ],
      "text": "Ankle"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "3×30 seconds per side, 2x daily"
    }
  ],
  "usage": "Evidence: moderate. Meta-analysis: increases dorsiflexion 2-3° across all durations [Radford 2006]",
  "note": [
    {
      "text": "Long, locked back knee — gastrocnemius lengthens",
      "authorString": "focus:internal"
    },
    {
      "text": "Drive the back heel into the floor",
      "authorString": "focus:external"
    },
    {
      "text": "Lean the chest forward toward the wall",
      "authorString": "focus:external"
    },
    {
      "text": "Front knee bends as the back leg stays straight",
      "authorString": "focus:tactile"
    }
  ],
  "relatedArtifact": [
    {
      "type": "citation",
      "label": "kisner-therapeutic-2017",
      "citation": "Kisner C, Colby LA, Borstad J. (2017). Therapeutic Exercise: Foundations and Techniques"
    },
    {
      "type": "citation",
      "label": "acsm-guidelines-2021",
      "citation": "American College of Sports Medicine. (2021). ACSM's Guidelines for Exercise Testing and Prescription",
      "document": {
        "url": "https://doi.org/10.4135/9781412994149.n165"
      }
    },
    {
      "type": "citation",
      "label": "radford-calf-stretch-meta-2006",
      "citation": "Radford JA, Burns J, Buchbinder R, Landorf KB, Cook C. (2006). Does Stretching Increase Ankle Dorsiflexion ROM?",
      "document": {
        "url": "https://doi.org/10.1136/bjsm.2006.029348"
      }
    },
    {
      "type": "citation",
      "label": "smith-foam-rolling-dorsiflexion-2019",
      "citation": "Smith JC, Washell BR, Aini MF, Brown S, Hall MC. (2019). Static Stretching and Foam Rolling on Ankle Dorsiflexion ROM",
      "document": {
        "url": "https://doi.org/10.1249/mss.0000000000001964"
      }
    },
    {
      "type": "citation",
      "label": "dinh-calf-stretch-wb-vs-nwb-2011",
      "citation": "Dinh NV, Freeman H, Granger J, Wong S, Johanson M. (2011). Calf Stretching: Non-Weight Bearing vs Weight Bearing",
      "document": {
        "url": "https://doi.org/10.1055/s-0030-1268505"
      }
    },
    {
      "type": "citation",
      "label": "youdas-calf-stretch-rom-2003",
      "citation": "Youdas JW, Krause DA, Egan KS, Therneau TM, Laskowski ER. (2003). Static Stretching of the Calf on Ankle Dorsiflexion ROM",
      "document": {
        "url": "https://doi.org/10.2519/jospt.2003.33.7.408"
      }
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Gastrocnemius"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "35616000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Soleus"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "78376008"
          }
        }
      ]
    }
  ]
}