{
  "resourceType": "ActivityDefinition",
  "id": "tendon-gliding-sequence",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/tendon-gliding-sequence",
  "version": "1",
  "name": "TendonGlidingSequence",
  "title": "Tendon Gliding Sequence",
  "status": "draft",
  "experimental": true,
  "description": "Sequential finger positions: straight → hook fist → straight fist → tabletop. Standard post-carpal-tunnel-release mobility protocol.",
  "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": "tendon-gliding-sequence",
          "display": "Tendon Gliding Sequence"
        }
      ]
    }
  ],
  "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": "10 reps of the full sequence, 3–4×/day (Peters 2016 Cochrane — widely used post-CTR)."
    }
  ],
  "usage": "Evidence: moderate. No isolated-lumbrical EMG validation.",
  "note": [
    {
      "text": "Quiet wrist — tendons slide through each finger shape",
      "authorString": "focus:internal"
    },
    {
      "text": "Cycle the hand through four precise positions in order",
      "authorString": "focus:external"
    },
    {
      "text": "Hold each shape for three seconds before changing",
      "authorString": "focus:external"
    },
    {
      "text": "Each shape is a snapshot — clean and complete",
      "authorString": "focus:imagery"
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Digitorum Superficialis"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "89895007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Digitorum Profundus"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "423541009"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Lumbricals (Hand)"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "88229007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Extensor Digitorum"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "50176000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Dorsal Interossei (Hand)"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "60618007"
          }
        }
      ]
    }
  ]
}