{
  "resourceType": "ActivityDefinition",
  "id": "resisted-forearm-pronation",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/resisted-forearm-pronation",
  "version": "1",
  "name": "ResistedForearmPronation",
  "title": "Resisted Forearm Pronation",
  "status": "draft",
  "experimental": true,
  "description": "A targeted forearm-strengthening exercise in which the seated athlete rotates the palm from a face-up (supinated) or neutral position toward face-down (pronated) against external resistance, typically an offset load such as a hammer or a dumbbell held at one end, or an elastic band. The elbow is kept flexed to roughly 90 degrees and pinned to the side or supported on a thigh/table so the rotation is isolated to the radioulnar joints rather than the shoulder. It builds concentric and eccentric control of forearm pronation for grip-, tool-, and racquet-based tasks and for rehabilitation after distal radius, elbow, or forearm injury.",
  "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": "resisted-forearm-pronation",
          "display": "Resisted Forearm Pronation"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "elbow",
          "display": "Elbow"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "20903007",
          "display": "Structure of proximal radioulnar joint"
        }
      ],
      "text": "Elbow"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "Strength focus: 2-3 sets of 10-15 controlled reps per arm, 2-3 sessions per week, progressing load as form allows. For tendinopathy or early rehab, use lighter resistance with higher reps (2-3 sets of 15-20) and emphasize the pain-free range and the eccentric phase."
    }
  ],
  "usage": "Evidence: moderate. Classic EMG work indicates pronator quadratus is active during pronation independent of speed and resistance, while pronator teres contribution rises with increasing load and rotational velocity; brachioradialis participates mainly when moving from full supination toward neutral.",
  "note": [
    {
      "text": "Sit with your elbow bent to about 90 degrees and tucked against your side or resting on your thigh so only your forearm rotates."
    },
    {
      "text": "Turn your palm to face the floor, as if slowly pouring water out of a cup, then let it return under control."
    },
    {
      "text": "Keep your wrist straight and quiet, and let the rotation come from the forearm rather than swinging the shoulder or flaring the elbow."
    },
    {
      "text": "Lower back to the start over two to three seconds to train the return phase, not just the turn down."
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Pronator Quadratus"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "13869007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Pronator Teres"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "29376000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Carpi Radialis"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "30339000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Brachioradialis"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "72111005"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Supinator"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "40678005"
          }
        }
      ]
    },
    {
      "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"
          }
        }
      ]
    }
  ]
}