{
  "resourceType": "ActivityDefinition",
  "id": "desk-wrist-extensor-stretch",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/desk-wrist-extensor-stretch",
  "version": "1",
  "name": "DeskWristExtensorStretch",
  "title": "Desk Wrist Extensor Stretch",
  "status": "draft",
  "experimental": true,
  "description": "Standing or sitting at a desk, place the back of the affected hand flat on the desk with the palm facing up and fingers pointing toward your body, elbow straight; gently press down and lean until you feel a stretch over the top of the forearm.",
  "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": "desk-wrist-extensor-stretch",
          "display": "Desk Wrist Extensor Stretch"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "wrist",
          "display": "Wrist"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "74670003",
          "display": "Structure of radiocarpal joint"
        }
      ],
      "text": "Wrist"
    },
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "elbow",
          "display": "Elbow"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "44034005",
          "display": "Structure of humeroulnar joint"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "20903007",
          "display": "Structure of proximal radioulnar joint"
        }
      ],
      "text": "Elbow"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "Hold 30 seconds per repetition, 3-4 repetitions, 2-3 times per day. Stretch to mild tension only (no sharp or nerve-like pain); can be done as a microbreak during prolonged desk/keyboard work."
    }
  ],
  "usage": "Evidence: limited.",
  "note": [
    {
      "text": "Keep the elbow fully straight and palm turned up (forearm pronated relative to a palm-down start) so the stretch reaches the top of the forearm, not just the wrist joint."
    },
    {
      "text": "Let the fingers stay soft and slightly curled so the finger extensors also lengthen; a clenched fist reduces the stretch."
    },
    {
      "text": "Ease into it slowly until you feel a mild pulling over the top of the forearm — a 3-4 out of 10, never a sharp or nervy pain."
    },
    {
      "text": "Breathe normally and hold steady rather than bouncing; relax further on each exhale."
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Extensor Carpi Radialis Brevis"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "86172000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Extensor Carpi Radialis Longus"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "39421004"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Extensor Carpi Ulnaris"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "113227003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Extensor Digitorum"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "50176000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Brachioradialis"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "72111005"
          }
        }
      ]
    }
  ]
}