{
  "resourceType": "ActivityDefinition",
  "id": "grip-squeeze-and-release",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/grip-squeeze-and-release",
  "version": "1",
  "name": "GripSqueezeAndRelease",
  "title": "Grip Squeeze and Release",
  "status": "draft",
  "experimental": true,
  "description": "Make a firm fist (squeeze a stress ball if available), hold 3 seconds, then fully open the hand with fingers spread. Trains forearm flexor strength + extensor recruitment.",
  "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": "grip-squeeze-and-release",
          "display": "Grip Squeeze and Release"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "hand",
          "display": "Hand"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "56103003",
          "display": "Structure of collateral ligaments of metacarpophalangeal joints"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "371232006",
          "display": "Structure of proximal interphalangeal joint of finger"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "725412007",
          "display": "Structure of distal interphalangeal joint"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "782474003",
          "display": "Structure of ligament of first carpometacarpal joint"
        }
      ],
      "text": "Hand"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "10 reps × 2–3 sets, 2–3×/day; hold each squeeze 3–5 s. Progress putty/ball resistance as tolerated."
    }
  ],
  "usage": "Evidence: moderate. Power grip is driven by FDP and FDS; grip force correlates with their activation. Wrist extensors (ECRB/ECRL) co-activate strongly to stabilise the wrist in ~30° extension — grip strength drops markedly with the wrist flexed (Fong & Ng 2001; O'Driscoll 1992).",
  "note": [
    {
      "text": "Squeeze slowly and fully, then open the hand all the way — both directions matter"
    },
    {
      "text": "Keep the wrist straight or slightly back, not bent forward"
    },
    {
      "text": "Wrap the thumb around to meet the fingers for a full power grip"
    },
    {
      "text": "Feel the forearm muscles work, not just the fingers"
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Digitorum Profundus"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "423541009"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Digitorum Superficialis"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "89895007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Pollicis Longus"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "82465007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Adductor Pollicis"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "60114005"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Pollicis Brevis"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "20588008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Lumbricals (Hand)"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "88229007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Palmar Interossei"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "85212008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Extensor Carpi Radialis Brevis"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "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": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "39421004"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Carpi Ulnaris"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "14437004"
          }
        }
      ]
    }
  ]
}