{
  "resourceType": "ActivityDefinition",
  "id": "pfm-lengthening-positions",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/pfm-lengthening-positions",
  "version": "1",
  "name": "PfmLengtheningPositions",
  "title": "Supported Pelvic Floor Lengthening Positions",
  "status": "draft",
  "experimental": true,
  "description": "Static holds in gravity-assisted positions that passively lengthen the pelvic floor. Modified butterfly (supine, soles together, knees apart) was most effective for PFM relaxation on sEMG, followed by deep squat with yoga block and child's pose. Hold 60–90 s with diaphragmatic breathing.",
  "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": "pfm-lengthening-positions",
          "display": "Supported Pelvic Floor Lengthening Positions"
        }
      ]
    }
  ],
  "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"
    },
    {
      "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": "lumbar-spine",
          "display": "Lumbar Spine"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "23526008",
          "display": "Structure of lumbar intervertebral disc"
        }
      ],
      "text": "Lumbar Spine"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "60–90 s hold × 3–5 cycles per position, 1×/day."
    }
  ],
  "usage": "Evidence: moderate.",
  "note": [
    {
      "text": "Soles together, knees apart and supported by pillows if they fall too low"
    },
    {
      "text": "Combine each hold with slow diaphragmatic breathing — the breath IS the release mechanism"
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Diaphragm"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "5798000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Adductor Group (Longus/Brevis/Magnus)"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Gracilis"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "2577006"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Pectineus"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "71875009"
          }
        }
      ]
    }
  ]
}