{
  "resourceType": "ActivityDefinition",
  "id": "scapular-stability-rows",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/scapular-stability-rows",
  "version": "1",
  "name": "ScapularStabilityRows",
  "title": "Scapular Stability Exercises (Rows / Scapular Retraction)",
  "status": "draft",
  "experimental": true,
  "description": "Cervico-scapulothoracic strengthening targeting middle and lower trapezius activation. Performed as seated or standing rows with resistance band, focusing on scapular retraction and depression. Improves pain and function in chronic neck pain by coordinating shoulder-neck movement patterns and counteracting rounded shoulder postures.",
  "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": "scapular-stability-rows",
          "display": "Scapular Stability Exercises (Rows / Scapular Retraction)"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "shoulder",
          "display": "Shoulder"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "264190008",
          "display": "Structure of scapulothoracic joint"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "85537004",
          "display": "Structure of glenohumeral joint"
        }
      ],
      "text": "Shoulder"
    },
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "cervical-spine",
          "display": "Cervical Spine"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "68818006",
          "display": "Structure of cervical intervertebral disc"
        }
      ],
      "text": "Cervical Spine"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "3×10-15 reps, 2-3x/week"
    }
  ],
  "usage": "Evidence: moderate.",
  "note": [
    {
      "text": "Long neck, lifted breastbone — middle and lower traps lead",
      "authorString": "focus:internal"
    },
    {
      "text": "Drive the elbows toward the back hip pockets",
      "authorString": "focus:external"
    },
    {
      "text": "Pull the band toward the lower ribs",
      "authorString": "focus:external"
    },
    {
      "text": "Pinch a coin between the lower shoulder blades at end-range",
      "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": "sun-cervicothoracic-2024",
      "citation": "Sun X, Chai L, Huang Q, Zhou H, Liu H. (2024). Effects of Exercise Combined With Cervicothoracic Spine Self-Mobilization on Chronic Non-Specific Neck Pain",
      "document": {
        "url": "https://doi.org/10.1038/s41598-024-55181-8"
      }
    },
    {
      "type": "citation",
      "label": "gross-neck-exercises-2015",
      "citation": "Gross A, Kay TM, Paquin JP, et al.. (2015). Exercises for Mechanical Neck Disorders",
      "document": {
        "url": "https://doi.org/10.1002/14651858.CD004250.pub5"
      }
    },
    {
      "type": "citation",
      "label": "mueller-neck-dose-response-2023",
      "citation": "Mueller J, Weinig J, Niederer D, Tenberg S, Mueller S. (2023). Resistance, Motor Control, and Mindfulness-Based Exercises Are Effective for Treating Chronic Nonspecific Neck Pain: A Systematic Review With Meta-Analysis and Dose-Response Meta-Regression",
      "document": {
        "url": "https://doi.org/10.2519/jospt.2023.11820"
      }
    },
    {
      "type": "citation",
      "label": "cho-thoracic-vs-cervical-2017",
      "citation": "Cho J, Lee E, Lee S. (2017). Upper Thoracic Spine Mobilization and Mobility Exercise Versus Upper Cervical Spine Mobilization and Stabilization Exercise in Individuals With Forward Head Posture: A Randomized Clinical Trial",
      "document": {
        "url": "https://doi.org/10.1186/s12891-017-1889-2"
      }
    },
    {
      "type": "successor",
      "label": "Progress seated rows to gravity-loaded prone Y/T raises for middle/lower trapezius (listed as rows progression); same muscle group, higher demand.",
      "display": "Prone Horizontal Abduction with External Rotation (Prone Y/T)",
      "resource": "ActivityDefinition/prone-horizontal-abduction-er"
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Middle Trapezius"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "31764008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Lower Trapezius"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "31764008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Rhomboid Major"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "88530003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Posterior Deltoid"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "35259002"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Latissimus Dorsi"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "15665001"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Pectoralis Major"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "60005003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Anterior Deltoid"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "35259002"
          }
        }
      ]
    }
  ]
}