{
  "resourceType": "ActivityDefinition",
  "id": "hip-abduction-strengthening",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/hip-abduction-strengthening",
  "version": "1",
  "name": "HipAbductionStrengthening",
  "title": "Hip Strengthening (Clamshells / Side-Lying Hip Abduction)",
  "status": "draft",
  "experimental": true,
  "description": "Hip abductor and extensor strengthening targeting gluteus medius and maximus. Includes clamshells and side-lying hip abduction. Addresses muscle weakness common in hip OA and improves functional stability for gait and single-leg activities.",
  "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": "hip-abduction-strengthening",
          "display": "Hip Strengthening (Clamshells / Side-Lying Hip Abduction)"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "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"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "3×15-20 reps per side, 2-3x/week"
    }
  ],
  "usage": "Evidence: strong.",
  "note": [
    {
      "text": "Quiet pelvis, stacked hips — glute med lifts the leg",
      "authorString": "focus:internal"
    },
    {
      "text": "Lift the heel toward the ceiling",
      "authorString": "focus:external"
    },
    {
      "text": "Aim the top knee out in line with the trunk",
      "authorString": "focus:external"
    },
    {
      "text": "Hand on the top hip stops it rolling backward",
      "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": "va-hip-knee-oa-2020",
      "citation": "Matthew Bair MD MS, John Cody MD, Jess Edison MD, et al.. (2020). The Non-Surgical Management of Hip & Knee Osteoarthritis (OA) (2020)",
      "document": {
        "url": "https://doi.org/10.1016/j.ijotn.2020.100840"
      }
    },
    {
      "type": "citation",
      "label": "cibulka-hip-oa-cpg-2017",
      "citation": "Cibulka MT, Bloom NJ, Enseki KR, et al.. (2017). Hip Pain and Mobility Deficits-Hip Osteoarthritis: Revision 2017",
      "document": {
        "url": "https://doi.org/10.2519/jospt.2017.0301"
      }
    },
    {
      "type": "successor",
      "label": "Progress floor side-lying abduction to a weight-bearing side-plank-with-abduction once lateral trunk endurance allows.",
      "display": "Side Plank with Hip Abduction",
      "resource": "ActivityDefinition/side-plank-hip-abduction"
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Gluteus Medius"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "78333006"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Gluteus Maximus"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "206007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Piriformis"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "75699001"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Adductor Group (Longus/Brevis/Magnus)"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        }
      ]
    }
  ]
}