{
  "resourceType": "ActivityDefinition",
  "id": "stair-calf-raise",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/stair-calf-raise",
  "version": "1",
  "name": "StairCalfRaise",
  "title": "Stair Calf Raise",
  "status": "draft",
  "experimental": true,
  "description": "Standing on a stair with the balls of both feet on the edge and heels hanging off, hold the handrail or wall for balance, press up onto your toes, then lower the heels below the step level for a full-range calf raise.",
  "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": "stair-calf-raise",
          "display": "Stair Calf Raise"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "ankle",
          "display": "Ankle"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "70258002",
          "display": "Structure of ankle joint"
        }
      ],
      "text": "Ankle"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "General strengthening: 3 sets of 12-15 controlled reps (2-3 s up, brief hold, 2-3 s lower below the step), 4-5 days per week, progressing to single-leg or added load. Achilles tendinopathy (eccentric emphasis): work toward 3 sets of 15 heel drops, twice daily, per the Alfredson protocol, using mild-to-moderate tolerable discomfort as the guide."
    }
  ],
  "usage": "Evidence: moderate. Standing heel raises produce high gastrocnemius and soleus activation; the straight-knee position biases the gastrocnemius while a slightly flexed knee shifts emphasis to the soleus. Peronei and deep posterior compartment (tibialis posterior, long toe flexors) act as synergists/stabilizers, more so on the unstable step edge.",
  "note": [
    {
      "text": "Rest only the balls of your feet on the stair edge with heels hanging free, and keep a light hand on the rail for balance, not for lifting."
    },
    {
      "text": "Press slowly straight up onto your toes over about 2-3 seconds, feeling the calves shorten, and pause briefly at the top."
    },
    {
      "text": "Lower under control until the heels sink below the step level and you feel a gentle stretch through the calf and Achilles, then reverse."
    },
    {
      "text": "Keep the ankles tracking straight over the middle toes so you neither roll out nor collapse in as you rise and lower."
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Gastrocnemius"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "35616000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Soleus"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "78376008"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Tibialis Posterior"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "74318005"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Hallucis Longus"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "471000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Digitorum Longus"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "18010003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Peroneus Longus (Fibularis Longus)"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "59831009"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Peroneus Brevis (Fibularis Brevis)"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "60771004"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Quadriceps Femoris"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "21989003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Tibialis Anterior"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "73508007"
          }
        }
      ]
    }
  ]
}