{
  "resourceType": "ActivityDefinition",
  "id": "tricep-extension",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/tricep-extension",
  "version": "1",
  "name": "TricepExtension",
  "title": "Tricep Extension (Overhead)",
  "status": "draft",
  "experimental": true,
  "description": "Overhead elbow extension with dumbbell or band. Fully lengthens the long head of the triceps across both joints. Complements pushing exercises.",
  "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": "tricep-extension",
          "display": "Tricep Extension (Overhead)"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "elbow",
          "display": "Elbow"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "44034005",
          "display": "Structure of humeroulnar joint"
        }
      ],
      "text": "Elbow"
    },
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "shoulder",
          "display": "Shoulder"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "85537004",
          "display": "Structure of glenohumeral joint"
        }
      ],
      "text": "Shoulder"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "5×10 at 70% 1RM, 2x/week; overhead for long head emphasis"
    }
  ],
  "usage": "Evidence: moderate. Overhead produces 1.5x greater long head hypertrophy (+28.5% vs +19.6%) over 12 weeks [Maeo 2023]",
  "note": [
    {
      "text": "Vertical upper arm, quiet shoulder — triceps extend the elbow",
      "authorString": "focus:internal"
    },
    {
      "text": "Drive the dumbbell toward the ceiling",
      "authorString": "focus:external"
    },
    {
      "text": "Lower the weight slowly behind the head over three seconds",
      "authorString": "focus:external"
    },
    {
      "text": "Free hand on biceps confirms upper arm stays vertical",
      "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": "maeo-triceps-overhead-hypertrophy-2023",
      "citation": "Maeo S, Wu Y, Huang M, et al.. (2023). Triceps Brachii Hypertrophy: Overhead vs Neutral Arm Position",
      "document": {
        "url": "https://doi.org/10.1080/17461391.2022.2100279"
      }
    },
    {
      "type": "citation",
      "label": "alves-triceps-shoulder-position-2018",
      "citation": "Alves D, Matta T, Oliveira L. (2018). Effect of Shoulder Position on Triceps Activity in Dumbbell Extensions",
      "document": {
        "url": "https://doi.org/10.23736/s0022-4707.17.06849-9"
      }
    },
    {
      "type": "citation",
      "label": "paoli-shoulder-rom-emg-2010",
      "citation": "Paoli A, Marcolin G, Petrone N. (2010). Influence of Different Ranges of Motion on Selective Recruitment of Shoulder Muscles",
      "document": {
        "url": "https://doi.org/10.1519/JSC.0b013e3181d756ea"
      }
    },
    {
      "type": "citation",
      "label": "saeterbakken-shoulder-press-2013",
      "citation": "Saeterbakken AH, Fimland MS. (2013). Effects of Body Position and Loading Modality on Muscle Activity and Strength in Shoulder Presses",
      "document": {
        "url": "https://doi.org/10.1519/JSC.0b013e318276b873"
      }
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Triceps Brachii"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "40284004"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Anconeus"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Biceps Brachii"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "16225001"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Latissimus Dorsi"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "15665001"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Brachialis"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "75915005"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Brachioradialis"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "72111005"
          }
        }
      ]
    }
  ]
}