{
  "resourceType": "ActivityDefinition",
  "id": "upper-cervical-extension-control",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/upper-cervical-extension-control",
  "version": "1",
  "name": "UpperCervicalExtensionControl",
  "title": "Upper Cervical Extension Control",
  "status": "draft",
  "experimental": true,
  "description": "A slow, small-range motor-control drill that trains you to extend the head at the top of the neck (the skull rocking back on the first vertebra) while keeping the lower neck quiet. Starting from a gentle chin tuck, you nod the head backward a short distance as if tipping your gaze up toward the ceiling, then return under control. The goal is precision and dissociation, not range or load.",
  "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": "upper-cervical-extension-control",
          "display": "Upper Cervical Extension Control"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "cervical-spine",
          "display": "Cervical Spine"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "20292002",
          "display": "Structure of atlantooccipital joint"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "68818006",
          "display": "Structure of cervical intervertebral disc"
        }
      ],
      "text": "Cervical Spine"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "Start with 1-2 sets of 8-10 slow, controlled reps, once or twice daily, prioritizing quality over quantity. Progress toward 2-3 sets and add 3-5 second end-range holds as control improves. Stop the set if fatigue causes the lower neck to take over or any symptoms appear."
    }
  ],
  "usage": "Evidence: limited. No exercise-specific EMG data is cited here; the suboccipital muscles are deep and small and are not readily or reliably captured by surface EMG, so muscle roles are assigned from applied anatomy and kinematics rather than measured activation.",
  "note": [
    {
      "text": "Imagine a small marble balanced on the tip of your nose and slowly roll it up toward the ceiling, then roll it back to level."
    },
    {
      "text": "Keep the lower neck long and still, like a mannequin from the shoulders to the jaw. Only the head, above the ears, tips back."
    },
    {
      "text": "Move slowly, about 3 seconds up and 3 seconds down, so you can feel the top of the neck working rather than swinging into it."
    },
    {
      "text": "Stay in a small, comfortable range. Stop short of any pinching, dizziness, or lightheadedness rather than pushing to end range."
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Suboccipital Muscles"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "244847002"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Semispinalis Capitis"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "2666009"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Splenius Capitis"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "1600003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Deep Cervical Flexors"
        },
        {
          "url": "role",
          "valueCode": "lengthening"
        }
      ]
    }
  ]
}