{
  "resourceType": "ActivityDefinition",
  "id": "straight-leg-raise",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/straight-leg-raise",
  "version": "1",
  "name": "StraightLegRaise",
  "title": "Straight Leg Raise",
  "status": "draft",
  "experimental": true,
  "description": "Supine hip flexion with knee extended. Patient lifts leg while keeping the knee straight. Common early quad and hip flexor exercise.",
  "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": "straight-leg-raise",
          "display": "Straight Leg Raise"
        }
      ]
    }
  ],
  "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": "3×10-15 reps per leg; progress with ankle weights"
    }
  ],
  "usage": "Evidence: strong. Psoas >60% MVIC at end-range; rectus femoris 40-50% MVIC [Okubo 2021]",
  "note": [
    {
      "text": "Locked knee, quiet trunk — hip flexors lift a long leg",
      "authorString": "focus:internal"
    },
    {
      "text": "Lift the heel toward the ceiling",
      "authorString": "focus:external"
    },
    {
      "text": "Keep the opposite leg pinned to the floor",
      "authorString": "focus:external"
    },
    {
      "text": "Both sides of the pelvis stay equally pressed down",
      "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": "va-hip-knee-oa-2020",
      "citation": "Matthew Bair MD MS, John Cody MD, Jess Edison MD, et al.. (2020). The Non-Surgical Management of Hip & Knee Osteoarthritis (OA) (2020)",
      "document": {
        "url": "https://doi.org/10.1016/j.ijotn.2020.100840"
      }
    },
    {
      "type": "citation",
      "label": "sharma-knee-oa-2021",
      "citation": "Sharma L. (2021). Osteoarthritis of the Knee",
      "document": {
        "url": "https://doi.org/10.1007/s40883-021-00226-x"
      }
    },
    {
      "type": "citation",
      "label": "escamilla-cruciate-loading-2012",
      "citation": "Escamilla RF, Macleod TD, Wilk KE, Paulos L, Andrews JR. (2012). Cruciate Ligament Loading During Common Knee Rehabilitation Exercises",
      "document": {
        "url": "https://doi.org/10.1177/0954411912451839"
      }
    },
    {
      "type": "citation",
      "label": "andersen-therapeutic-vs-heavy-2006",
      "citation": "Andersen LL, Magnusson SP, Nielsen M, et al.. (2006). Neuromuscular Activation in Conventional Therapeutic Exercises and Heavy Resistance Exercises: Implications for Rehabilitation",
      "document": {
        "url": "https://doi.org/10.1093/ptj/86.5.683"
      }
    },
    {
      "type": "citation",
      "label": "okubo-psoas-slr-2021",
      "citation": "Okubo Y, Kaneoka K, Hasebe K, et al.. (2021). Differential Activation of Psoas Major and Rectus Femoris During Active Straight Leg Raise to End Range",
      "document": {
        "url": "https://doi.org/10.1016/j.jelekin.2021.102588"
      }
    },
    {
      "type": "citation",
      "label": "juan-hip-flexor-activation-2024",
      "citation": "Juan J, Leff G, Kevorken K, Jeanfavre M. (2024). Hip Flexor Muscle Activation During Common Rehabilitation and Strength Exercises",
      "document": {
        "url": "https://doi.org/10.3390/jcm13216617"
      }
    },
    {
      "type": "citation",
      "label": "thongduang-quad-emg-okc-ckc-2022",
      "citation": "Thongduang P, Chatchawan U, Puntumetakul R, Yamauchi J, Peungsuwan P. (2022). Quadriceps EMG Activity in Closed and Open Kinetic-Chain Exercises",
      "document": {
        "url": "https://doi.org/10.3390/ijerph191912929"
      }
    },
    {
      "type": "citation",
      "label": "beales-slr-motor-control-2009",
      "citation": "Beales DJ, O'Sullivan PB, Briffa NK. (2009). Motor Control Patterns During an Active Straight Leg Raise in Pain-Free Subjects",
      "document": {
        "url": "https://doi.org/10.1016/j.jelekin.2009.05.003"
      }
    },
    {
      "type": "citation",
      "label": "hu-psoas-hip-flexor-2011",
      "citation": "Hu H, Meijer OG, van Dieën JH, et al.. (2011). Is the Psoas a Hip Flexor in the Active Straight Leg Raise?",
      "document": {
        "url": "https://doi.org/10.1007/s00586-010-1508-5"
      }
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Iliopsoas"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "68455001"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Rectus Femoris"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "72226001"
          }
        }
      ]
    },
    {
      "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": "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": "Tensor Fasciae Latae"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "28190000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Hamstrings (Group)"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Gluteus Maximus"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "206007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Biceps Femoris — Long Head"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "55190004"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Semitendinosus"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "50340007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Semimembranosus"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "84010001"
          }
        }
      ]
    }
  ]
}