{
  "resourceType": "ActivityDefinition",
  "id": "sitting-ccf-oblique-band",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/sitting-ccf-oblique-band",
  "version": "1",
  "name": "SittingCcfObliqueBand",
  "title": "Sitting Craniocervical Flexion with Oblique Band Resistance",
  "status": "draft",
  "experimental": true,
  "description": "Seated craniocervical flexion performed against an elastic band anchored to the ipsilateral side in an oblique plane (combining lateral flexion with extension resistance). Ipsilateral oblique resistance preferentially activates longus colli compared to straight lateral or contralateral forces.",
  "useContext": [
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "user"
      },
      "valueCodeableConcept": {
        "text": "difficulty: intermediate"
      }
    }
  ],
  "topic": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "sitting-ccf-oblique-band",
          "display": "Sitting Craniocervical Flexion with Oblique Band Resistance"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "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"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "20292002",
          "display": "Structure of atlantooccipital joint"
        }
      ],
      "text": "Cervical Spine"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "10 reps × 10-sec holds, 2×/day for 6 weeks. Moderate elastic band tension, anchored at shoulder height on the ipsilateral side."
    }
  ],
  "usage": "Evidence: moderate. Longus colli activation: ipsilateral oblique > contralateral (Cohen's d = -0.82). Straight lateral resistance activates SCM more — avoid. Sitting with oblique resistance ≈ supine CCF [Prodoehl 2025].",
  "note": [
    {
      "text": "Long neck, soft tuck — base of skull glides back",
      "authorString": "focus:internal"
    },
    {
      "text": "Resist the band's diagonal pull without turning your head",
      "authorString": "focus:external"
    },
    {
      "text": "Hold the gaze level on the horizon",
      "authorString": "focus:external"
    },
    {
      "text": "Palpate the SCM — it stays soft against the band",
      "authorString": "focus:tactile"
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Deep Cervical Flexors"
        },
        {
          "url": "role",
          "valueCode": "primary"
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Sternocleidomastoid"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "22823000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Semispinalis Capitis"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "2666009"
          }
        }
      ]
    }
  ]
}