{
  "resourceType": "ActivityDefinition",
  "id": "sensory-reeducation-mirror-therapy",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/sensory-reeducation-mirror-therapy",
  "version": "1",
  "name": "SensoryReeducationMirrorTherapy",
  "title": "Sensory Re-education with Mirror Therapy",
  "status": "draft",
  "experimental": true,
  "description": "Phase 1 (early re-innervation): texture and shape identification with eyes open, then closed. Phase 2 (after 2-point discrimination returns): stereognosis and locognosia. Mirror therapy enhances cortical activation.",
  "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": "sensory-reeducation-mirror-therapy",
          "display": "Sensory Re-education with Mirror Therapy"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "hand",
          "display": "Hand"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "56103003",
          "display": "Structure of collateral ligaments of metacarpophalangeal joints"
        }
      ],
      "text": "Hand"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "Classical SRE: 5–10 min × 4×/day. Mirror therapy + SRE: 12 weeks, frequency per protocol."
    }
  ],
  "usage": "Evidence: moderate. Not muscle-specific. Mirror therapy + SRE has moderate evidence for dexterity and functional outcomes [Xia 2021; Chen 2022].",
  "note": [
    {
      "text": "Calm, focused attention — sensory cortex recalibrates",
      "authorString": "focus:internal"
    },
    {
      "text": "Watch the mirror image of the unaffected hand moving",
      "authorString": "focus:external"
    },
    {
      "text": "Identify each texture by touch with eyes closed",
      "authorString": "focus:external"
    },
    {
      "text": "Reflected hand belongs to the affected side",
      "authorString": "focus:imagery"
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Lumbricals (Hand)"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "88229007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Dorsal Interossei (Hand)"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "60618007"
          }
        }
      ]
    }
  ]
}