{
  "resourceType": "ActivityDefinition",
  "id": "thumb-radial-abduction",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/thumb-radial-abduction",
  "version": "1",
  "name": "ThumbRadialAbduction",
  "title": "Thumb Radial Abduction",
  "status": "draft",
  "experimental": true,
  "description": "A targeted hand-strengthening exercise in which the thumb is moved away from the index finger within the plane of the palm (radial abduction / extension at the carpometacarpal joint), against gravity or elastic resistance. It isolates the deep radial-side extrinsic thumb muscles that govern the outer edge of the thumb web space and column stability of the first ray.",
  "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": "thumb-radial-abduction",
          "display": "Thumb Radial Abduction"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "hand",
          "display": "Hand"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "782474003",
          "display": "Structure of ligament of first carpometacarpal joint"
        }
      ],
      "text": "Hand"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "2-3 sets of 10-15 slow repetitions per hand, 3-5 days per week, with a 1-2 second hold at end range; add a light elastic band once bodyweight/gravity motion is pain-free and easy."
    }
  ],
  "usage": "Evidence: limited. The abductor pollicis longus is anatomically the prime radial abductor of the thumb, with the extensor pollicis brevis as its main assistant; formal EMG quantification specific to this isolated resisted exercise is limited.",
  "note": [
    {
      "text": "Rest your forearm and hand on a table with the thumb side up (neutral wrist), so the thumb can travel outward against gravity."
    },
    {
      "text": "Lead with the tip of the thumb and move it toward the ceiling, away from the index finger, as if opening the web space wide."
    },
    {
      "text": "Keep the thumb long and the knuckle relatively straight; avoid curling or bending the tip so the motion stays at the base of the thumb."
    },
    {
      "text": "Move up slowly over about two seconds, pause at the top, then lower under control rather than letting it drop."
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Abductor Pollicis Longus"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "25541006"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Extensor Pollicis Brevis"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "38259003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Abductor Pollicis Brevis"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "32573001"
          }
        }
      ]
    }
  ]
}