{
  "resourceType": "ActivityDefinition",
  "id": "upper-cervical-rotation-drill",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/upper-cervical-rotation-drill",
  "version": "1",
  "name": "UpperCervicalRotationDrill",
  "title": "Upper Cervical Rotation Drill",
  "status": "draft",
  "experimental": true,
  "description": "A gentle, controlled drill that isolates rotation at the top of the neck — the atlanto-axial (C1-C2) joint, which produces roughly half of the head's total turning range. By first tucking the chin to nod the head slightly forward, the lower neck segments are \"locked out,\" so the small rotation that remains happens almost entirely at the upper cervical joints. The head then turns side to side through a short, comfortable arc while the eyes and jaw stay relaxed. It is trained for mobility and motor control rather than strength.",
  "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-rotation-drill",
          "display": "Upper Cervical Rotation Drill"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "cervical-spine",
          "display": "Cervical Spine"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "62555009",
          "display": "Structure of atlantoaxial joint"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "68818006",
          "display": "Structure of cervical intervertebral disc"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "20292002",
          "display": "Structure of atlantooccipital joint"
        }
      ],
      "text": "Cervical Spine"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "Perform 1-2 sets of 5-8 slow rotations per side, once or twice daily. Move only within a pain-free, dizziness-free range; quality and control matter more than range or repetitions. Stop and reassess if you feel dizziness, nausea, visual changes, or arm symptoms."
    }
  ],
  "usage": "Evidence: limited.",
  "note": [
    {
      "text": "Imagine a thin skewer running straight up through the crown of your head; turn to slide your gaze along a wall, keeping that skewer vertical."
    },
    {
      "text": "First make a subtle chin nod, as if saying a small 'yes,' then turn — this locks the lower neck so the top of the neck does the work."
    },
    {
      "text": "Stay inside a pain-free, dizziness-free arc; you should feel the turn happen high, just below the base of the skull, not a big sweep of the whole neck."
    },
    {
      "text": "Move slowly — about two to three seconds to turn, pause a beat at the end, and return with control; let the jaw, tongue, and shoulders stay soft."
    }
  ],
  "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": "Splenius Capitis"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "1600003"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Sternocleidomastoid"
        },
        {
          "url": "role",
          "valueCode": "secondary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "22823000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Splenius Cervicis"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "61046001"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Levator Scapulae"
        },
        {
          "url": "role",
          "valueCode": "synergist"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "11327007"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Deep Cervical Flexors"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Multifidus"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "5709001"
          }
        }
      ]
    }
  ]
}