{
  "resourceType": "ActivityDefinition",
  "id": "overhead-press",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/overhead-press",
  "version": "1",
  "name": "OverheadPress",
  "title": "Overhead Press (Seated)",
  "status": "draft",
  "experimental": true,
  "description": "Seated shoulder press with dumbbells or resistance band. Combines shoulder flexion and abduction to lift weight overhead. Foundational upper extremity strengthening exercise.",
  "useContext": [
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "user"
      },
      "valueCodeableConcept": {
        "text": "difficulty: intermediate"
      }
    }
  ],
  "topic": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "overhead-press",
          "display": "Overhead Press (Seated)"
        }
      ]
    }
  ],
  "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"
    },
    {
      "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"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "3×8-12 reps; seated for stability"
    }
  ],
  "usage": "Evidence: moderate. Anterior deltoid 60-90% MVIC; middle deltoid 50-80% MVIC; standing increases activation 8-15% [Saeterbakken 2013]",
  "note": [
    {
      "text": "Tall trunk, soft jaw — press lives in the front of the shoulder",
      "authorString": "focus:internal"
    },
    {
      "text": "Drive the dumbbells straight toward the ceiling",
      "authorString": "focus:external"
    },
    {
      "text": "Stack the wrists over the elbows over the shoulders",
      "authorString": "focus:external"
    },
    {
      "text": "Ribs down, glutes squeezed against the bench",
      "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": "coratella-overhead-press-2022",
      "citation": "Coratella G, Tornatore G, Longo S, Esposito F, Cè E. (2022). Front vs Back and Barbell vs Machine Overhead Press",
      "document": {
        "url": "https://doi.org/10.3389/fphys.2022.825880"
      }
    },
    {
      "type": "citation",
      "label": "paoli-shoulder-rom-emg-2010",
      "citation": "Paoli A, Marcolin G, Petrone N. (2010). Influence of Different Ranges of Motion on Selective Recruitment of Shoulder Muscles",
      "document": {
        "url": "https://doi.org/10.1519/JSC.0b013e3181d756ea"
      }
    },
    {
      "type": "citation",
      "label": "saeterbakken-shoulder-press-2013",
      "citation": "Saeterbakken AH, Fimland MS. (2013). Effects of Body Position and Loading Modality on Muscle Activity and Strength in Shoulder Presses",
      "document": {
        "url": "https://doi.org/10.1519/JSC.0b013e318276b873"
      }
    },
    {
      "type": "citation",
      "label": "blazkiewicz-overhead-equipment-2022",
      "citation": "Błażkiewicz M, Hadamus A. (2022). The Effect of the Weight and Type of Equipment on Shoulder and Back Muscle Activity During the Overhead Press",
      "document": {
        "url": "https://doi.org/10.3390/s22249762"
      }
    },
    {
      "type": "citation",
      "label": "williams-unstable-overhead-2020",
      "citation": "Williams MR, Hendricks DS, Dannen MJ, Arnold AM, Lawrence MA. (2020). Activity of Shoulder Stabilizers and Prime Movers During an Unstable Overhead Press",
      "document": {
        "url": "https://doi.org/10.1519/JSC.0000000000002660"
      }
    },
    {
      "type": "predecessor",
      "label": "Regress the loaded overhead-flexion pattern to unloaded wall-based scapular upward-rotation mechanics when overhead load is painful (listed as overhead-press regression).",
      "display": "Wall Slide",
      "resource": "ActivityDefinition/wall-slide"
    }
  ],
  "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": "Middle 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": "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": "Triceps Brachii"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "40284004"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Upper Trapezius"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "31764008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Serratus Anterior"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "18346003"
          }
        }
      ]
    },
    {
      "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": "Pectoralis Major"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "60005003"
          }
        }
      ]
    },
    {
      "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": "Biceps Brachii"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "16225001"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Brachialis"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "75915005"
          }
        }
      ]
    },
    {
      "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"
          }
        }
      ]
    }
  ]
}