{
  "resourceType": "ActivityDefinition",
  "id": "sit-to-stand",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/sit-to-stand",
  "version": "1",
  "name": "SitToStand",
  "title": "Sit-to-Stand",
  "status": "draft",
  "experimental": true,
  "description": "Functional transfer exercise. Patient rises from a seated position without using arms, emphasizing lower extremity strength and weight shift.",
  "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": "sit-to-stand",
          "display": "Sit-to-Stand"
        }
      ]
    }
  ],
  "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": "knee",
          "display": "Knee"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "129159008",
          "display": "Structure of femorotibial joint"
        }
      ],
      "text": "Knee"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "3×10 reps, daily; progress to 5×STS timed test"
    }
  ],
  "usage": "Evidence: strong.",
  "note": [
    {
      "text": "Long spine — chest leads, glutes and quads finish",
      "authorString": "focus:internal"
    },
    {
      "text": "Drive the floor away through both heels",
      "authorString": "focus:external"
    },
    {
      "text": "Reach the chest forward over the toes before standing",
      "authorString": "focus:external"
    },
    {
      "text": "Stand up like the chair pushes you toward the ceiling",
      "authorString": "focus:imagery"
    }
  ],
  "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": "roldan-jimenez-sit-to-stand-emg-2015",
      "citation": "Roldán-Jiménez C, Bennett P, Cuesta-Vargas AI. (2015). Muscular Activity and Fatigue in Lower-Limb and Trunk Muscles During Different Sit-to-Stand Tests",
      "document": {
        "url": "https://doi.org/10.1371/journal.pone.0141675"
      }
    },
    {
      "type": "citation",
      "label": "goulart-sit-to-stand-pattern-1999",
      "citation": "Goulart FR, Valls-Solé J. (1999). Patterned Electromyographic Activity in the Sit-to-Stand Movement",
      "document": {
        "url": "https://doi.org/10.1016/s1388-2457(99)00109-1"
      }
    },
    {
      "type": "citation",
      "label": "cuesta-vargas-sit-to-stand-water-2013",
      "citation": "Cuesta-Vargas AI, Cano-Herrera CL, Heywood S. (2013). Analysis of the Neuromuscular Activity During Rising From a Chair in Water and on Dry Land",
      "document": {
        "url": "https://doi.org/10.1016/j.jelekin.2013.06.001"
      }
    },
    {
      "type": "citation",
      "label": "sadeh-sit-to-stand-biomechanics-2023",
      "citation": "Sadeh S, Gobert D, Shen KH, Foroughi F, Hsiao HY. (2023). Biomechanical and Neuromuscular Control of Sit-to-Stand in Young and Older Adults",
      "document": {
        "url": "https://doi.org/10.1016/j.clinbiomech.2023.106068"
      }
    },
    {
      "type": "citation",
      "label": "alcazar-sit-to-stand-power-2021",
      "citation": "Alcazar J, Alegre LM, Suetta C, et al.. (2021). Threshold of Relative Muscle Power Required to Rise From a Chair",
      "document": {
        "url": "https://doi.org/10.1249/MSS.0000000000002717"
      }
    },
    {
      "type": "successor",
      "label": "5×5 sit-to-stands from a standard chair without hand push-off",
      "display": "Squat",
      "resource": "ActivityDefinition/squat"
    },
    {
      "type": "predecessor",
      "label": "Knee pain above 3/10, or the athlete needs to pull on the support to rise",
      "display": "Countertop-Supported Squat",
      "resource": "ActivityDefinition/countertop-supported-squat"
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Quadriceps Femoris"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "21989003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Gluteus Maximus"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "206007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Hamstrings (Group)"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        }
      ]
    },
    {
      "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": "Transversus Abdominis"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "86493009"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Tibialis Anterior"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "73508007"
          }
        }
      ]
    }
  ]
}