{
  "resourceType": "ActivityDefinition",
  "id": "downward-dog",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/downward-dog",
  "version": "1",
  "name": "DownwardDog",
  "title": "Downward Dog (Adho Mukha Svanasana)",
  "status": "draft",
  "experimental": true,
  "description": "From hands-and-knees, tuck the toes and lift the hips up and back until the body forms an inverted V, arms and spine in one long line and knees softly extending. Press the floor away through spread fingers, reach the sit bones toward the ceiling, and let the heels sink toward the floor only as far as a neutral spine allows. Hold while breathing steadily, keeping the head relaxed between the upper arms.",
  "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": "downward-dog",
          "display": "Downward Dog (Adho Mukha Svanasana)"
        }
      ]
    }
  ],
  "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"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "264190008",
          "display": "Structure of scapulothoracic joint"
        }
      ],
      "text": "Shoulder"
    },
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "elbow",
          "display": "Elbow"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "44034005",
          "display": "Structure of humeroulnar joint"
        }
      ],
      "text": "Elbow"
    },
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "hip",
          "display": "Hip"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "24136001",
          "display": "Structure of hip joint"
        }
      ],
      "text": "Hip"
    },
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "knee",
          "display": "Knee"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "129159008",
          "display": "Structure of femorotibial joint"
        }
      ],
      "text": "Knee"
    },
    {
      "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"
    },
    {
      "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"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "Hold 20-30 seconds (about 5 slow breaths) for 3-5 repetitions, most days of the week if used for hamstring/calf flexibility — consistent with general static-stretching dosage literature (30 s holds, repeated). No pose-specific dose-response trials exist, so strengthening-oriented flow dosing is by convention rather than evidence."
    }
  ],
  "usage": "Evidence: limited. Small surface-EMG studies of hatha yoga poses (mostly in healthy adults, including older adults in the Yoga Empowers Seniors Study line of work) report low-to-moderate activation in downward dog: notable serratus anterior and trapezius activity from the weight-bearing upward-rotated scapula, moderate triceps and anterior deltoid activity, and modest erector spinae and abdominal activity for trunk control. Force-plate work shows roughly 55-65 percent of body weight borne through the upper limbs, which is why it is used to build wrist and shoulder weight-bearing tolerance. Hamstring and triceps surae activity is minimal — those muscles are primarily on stretch. Samples are small and protocols heterogeneous, so treat the numbers as indicative rather than definitive.",
  "note": [
    {
      "text": "Press the floor away from you and reach your hips up and back toward the wall behind you."
    },
    {
      "text": "Spread your fingers wide and root down through the knuckles so the wrists share the load."
    },
    {
      "text": "Bend your knees as much as you need to keep your back long — hips high beats heels down."
    },
    {
      "text": "Let your head hang relaxed between your arms, ears in line with your upper arms."
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Anterior Deltoid"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "35259002"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Serratus Anterior"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "18346003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Triceps Brachii"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "40284004"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Lower Trapezius"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "31764008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Upper Trapezius"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "31764008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Quadriceps Femoris"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "21989003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Infraspinatus"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "72573008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Supraspinatus"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "6423006"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Subscapularis"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "90588001"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Teres Minor"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "51159009"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Erector Spinae Group"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "44947003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Transversus Abdominis"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "86493009"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Rectus Abdominis"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "31243008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Digitorum Superficialis"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "89895007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Hamstrings (Group)"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Gastrocnemius"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "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": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "78376008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Gluteus Maximus"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "206007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Latissimus Dorsi"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "15665001"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Pectoralis Major"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "60005003"
          }
        }
      ]
    }
  ]
}