{
  "resourceType": "ActivityDefinition",
  "id": "wrist-curls-flexion-extension",
  "url": "https://bodyiq.dev/fhir/ActivityDefinition/wrist-curls-flexion-extension",
  "version": "1",
  "name": "WristCurlsFlexionExtension",
  "title": "Wrist Curls (Flexion/Extension)",
  "status": "draft",
  "experimental": true,
  "description": "Seated forearm-on-thigh wrist curls in both flexion and extension directions with light dumbbells. Wrist extensors function as primary stabilizers during dynamic movements with co-contraction ratios of 2.28 during flexion.",
  "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": "wrist-curls-flexion-extension",
          "display": "Wrist Curls (Flexion/Extension)"
        }
      ]
    }
  ],
  "bodySite": [
    {
      "coding": [
        {
          "system": "https://bodyiq.dev/fhir/CodeSystem/exercise",
          "code": "wrist",
          "display": "Wrist"
        },
        {
          "system": "http://snomed.info/sct",
          "code": "74670003",
          "display": "Structure of radiocarpal joint"
        }
      ],
      "text": "Wrist"
    }
  ],
  "kind": "ServiceRequest",
  "dosage": [
    {
      "text": "3×10-15 reps each direction, 3x/week"
    }
  ],
  "usage": "Evidence: limited. Wrist extensors co-contraction ratio 2.28 during flexion vs 0.32 during extension — extensors highly active as stabilizers [Forman 2020]",
  "note": [
    {
      "text": "Quiet forearm — only the wrist curls and uncurls",
      "authorString": "focus:internal"
    },
    {
      "text": "Lift the dumbbell toward the ceiling, then lower past horizontal",
      "authorString": "focus:external"
    },
    {
      "text": "Take three slow seconds on the way down",
      "authorString": "focus:external"
    },
    {
      "text": "Forearm stays glued to the thigh throughout",
      "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": "successor",
      "label": "The 6-direction node's notes state it consolidates isolated wrist curls; progressing from isolated flexion/extension to comprehensive 6-direction loading is a harder, more advanced variant.",
      "display": "6-Direction Wrist Resistance Training",
      "resource": "ActivityDefinition/wrist-resistance-6-direction"
    }
  ],
  "extension": [
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Carpi Radialis"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "30339000"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Flexor Carpi Ulnaris"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "14437004"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Extensor Carpi Radialis Longus"
        },
        {
          "url": "role",
          "valueCode": "primary"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "39421004"
          }
        }
      ]
    },
    {
      "url": "https://bodyiq.dev/fhir/StructureDefinition/muscle-involvement",
      "extension": [
        {
          "url": "muscle",
          "valueString": "Extensor Digitorum"
        },
        {
          "url": "role",
          "valueCode": "stabilizer"
        },
        {
          "url": "coding",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "50176000"
          }
        }
      ]
    }
  ]
}