{
  "resourceType": "ActivityDefinition",
  "id": "doorway-pec-stretch",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/doorway-pec-stretch",
  "version": "1",
  "name": "DoorwayPecStretch",
  "title": "Doorway Pectoralis Stretch",
  "status": "draft",
  "experimental": true,
  "description": "Standing in doorway with forearm on frame, leaning forward. Arm height changes which portion is stretched: 45° ABD targets clavicular, 90° targets sternal, 135° targets abdominal portion. 8 weeks of pectoralis stretching (15 min/day, 4 days/week) produces ROM, strength, and muscle thickness gains comparable to resistance training.",
  "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": "doorway-pec-stretch",
          "display": "Doorway Pectoralis Stretch"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "shoulder",
          "display": "Shoulder"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "85537004",
          "display": "Structure of glenohumeral joint"
        }
      ],
      "text": "Shoulder"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "2-4 reps of 30-60 seconds at each arm position (45°, 90°, 135°), 4+ days/week [Wohlann 2024]"
    }
  ],
  "usage": "Evidence: moderate. Sternocostal region shows greater slack stiffness than abdominal [Wolfram 2023]. 8 weeks stretching: comparable to resistance training for ROM/strength/thickness [Wohlann 2024]",
  "note": [
    {
      "text": "Open chest, soft jaw — front of shoulder lengthens",
      "authorString": "focus:internal"
    },
    {
      "text": "Step the back foot through the doorway slowly",
      "authorString": "focus:external"
    },
    {
      "text": "Press the forearm steadily into the door frame",
      "authorString": "focus:external"
    },
    {
      "text": "Sternum opens like a window swinging out",
      "authorString": "focus:imagery"
    }
  ],
  "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"
      }
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Pectoralis Major"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "60005003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Anterior Deltoid"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "35259002"
          }
        }
      ]
    }
  ]
}