{
  "resourceType": "ActivityDefinition",
  "id": "prone-press-up",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/prone-press-up",
  "version": "1",
  "name": "PronePressUp",
  "title": "Prone Press-Up (McKenzie)",
  "status": "draft",
  "experimental": true,
  "description": "Lie face-down on the floor (no equipment needed) and press your upper body up with your arms while your hips and low back stay relaxed, letting the lumbar spine extend passively.",
  "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": "prone-press-up",
          "display": "Prone Press-Up (McKenzie)"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "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"
    },
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "thoracic-spine",
          "display": "Thoracic Spine"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "5261000",
          "display": "Structure of thoracic intervertebral disc"
        }
      ],
      "text": "Thoracic Spine"
    },
    {
      "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": "elbow",
          "display": "Elbow"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "44034005",
          "display": "Structure of humeroulnar joint"
        }
      ],
      "text": "Elbow"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "Typically 10 repetitions per set, holding the top position 1-2 seconds, repeated roughly every 2-3 hours (about 6-8 sessions per day) during an acute extension-responsive episode; reduce frequency as symptoms centralize and resolve."
    }
  ],
  "usage": "Evidence: moderate.",
  "note": [
    {
      "text": "Keep your hips, buttocks, and low back completely relaxed and let your arms do all the work — the belly and pelvis stay resting on the floor."
    },
    {
      "text": "Press up only as far as pain allows, then lower back down; aim to gain a little more range with each repetition as symptoms permit."
    },
    {
      "text": "Watch where your symptoms go — if pain moves out of the leg and toward the center of your back (centralizes), that is the right direction; stop and reassess if it moves down the leg."
    },
    {
      "text": "Exhale as you press up to help the low back settle into the sag position."
    }
  ],
  "extension": [
    {
      "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": "Anterior Deltoid"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "35259002"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Pectoralis Major"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "60005003"
          }
        }
      ]
    },
    {
      "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": "Rectus Abdominis"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "31243008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "External Oblique"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "1179024003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Internal Oblique"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "1179024003"
          }
        }
      ]
    }
  ]
}