{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:16:51Z","timestamp":1783682211961,"version":"3.55.0"},"reference-count":56,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008459","name":"University of Calgary","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019713","name":"Branch Out Neurological Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019713","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009003","name":"Hotchkiss Brain Institute, University of Calgary","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009003","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Aerobic exercise testing helps facilitate recovery post\u2010concussion. Current protocols (Calgary Concussion Cycling Test: CCCT) are inaccessible for athletes with lower\u2010body impairments (i.e. Para athletes). This study compared physiological parameters for a novel arm crank test, the Calgary Adapted aRm Ergometer (CARE) test, with the CCCT. Twenty non\u2010disabled adults (10F:10M, aged 18\u201351) completed CCCT and CARE to volitional fatigue. Middle cerebral artery velocity (MCAv), heart rate (HR), mean arterial pressure (MAP) and end\u2010tidal carbon dioxide () were continuously measured throughout exertion. Bland\u2013Altman with 95% limits\u2010of\u2010agreement (LoA), mean differences with effect size measurement and intraclass correlation (ICC) compared CCCT to CARE at 25%, 50%, 75% and 100% of test exertion levels. Test duration was comparable between protocols (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.86). HR mean differences between CCCT and CARE ranged from 2\u00a0bpm (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.45) at 25% to 8\u00a0bpm (\n                    <jats:italic>P\u00a0<\/jats:italic>\n                    &lt;\u00a00.05) at 100% effort level (negligible\u2010to\u2010medium effect sizes). MCAv mean differences increased from 1.5\u00a0cm\/s at 25% (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.45) to 5.4\u00a0cm\/s at 100% effort (\n                    <jats:italic>P\u00a0<\/jats:italic>\n                    &lt;\u00a00.05) (small effect sizes). MAP remained stable: 4.1\u00a0mmHg at 25% (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.11) and 4.8\u00a0mmHg at 100% effort (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.076) (small effect sizes).  mean differences increased until 75% effort level (2.4 to 4.9\u00a0Torr,\n                    <jats:italic>P\u00a0<\/jats:italic>\n                    &lt;\u00a00.05, medium\u2010to\u2010large effect size). ICC was good\u2010to\u2010moderate across all measurements with 95% LoA widening with increased test intensity. The CARE test represents a promising alternative to traditional lower body exercise tests, demonstrating robust physiological responses and moderate comparability with the CCCT. CARE vs. CCCT differences likely resulted from different total muscle mass engagement between the upper and lower body.\n                  <\/jats:p>","DOI":"10.1113\/ep093263","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T22:40:10Z","timestamp":1773960010000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["CARE\u2010ing for concussions: Development of the Calgary Adapted aRm Ergometer (CARE) exertion test: A physiological alternative to the Calgary Concussion Cycle Test"],"prefix":"10.1113","author":[{"given":"Jonathan D.","family":"Smirl","sequence":"first","affiliation":[{"name":"Cerebrovascular Concussion Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Sport Injury Prevention Research Centre, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Human Performance Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Hotchkiss Brain Institute University of Calgary  Calgary Alberta Canada"},{"name":"Integrated Concussion Research Program University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2142-7669","authenticated-orcid":false,"given":"Joshua J.","family":"Burkart","sequence":"additional","affiliation":[{"name":"Cerebrovascular Concussion Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Sport Injury Prevention Research Centre, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Human Performance Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Hotchkiss Brain Institute University of Calgary  Calgary Alberta Canada"},{"name":"Integrated Concussion Research Program University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5397-208X","authenticated-orcid":false,"given":"Matthew G.","family":"Neill","sequence":"additional","affiliation":[{"name":"Cerebrovascular Concussion Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Sport Injury Prevention Research Centre, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Human Performance Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Hotchkiss Brain Institute University of Calgary  Calgary Alberta Canada"},{"name":"Integrated Concussion Research Program University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Michel","family":"Galarneau","sequence":"additional","affiliation":[{"name":"Sport Injury Prevention Research Centre, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth K. S.","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Cerebrovascular Concussion Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Sport Injury Prevention Research Centre, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Human Performance Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Hotchkiss Brain Institute University of Calgary  Calgary Alberta Canada"},{"name":"Integrated Concussion Research Program University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9756-5793","authenticated-orcid":false,"given":"Joel S.","family":"Burma","sequence":"additional","affiliation":[{"name":"Cerebrovascular Concussion Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Sport Injury Prevention Research Centre, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Human Performance Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Hotchkiss Brain Institute University of Calgary  Calgary Alberta Canada"},{"name":"Integrated Concussion Research Program University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan E.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Cerebrovascular Concussion Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Leddy","sequence":"additional","affiliation":[{"name":"UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences SUNY at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad N.","family":"Haider","sequence":"additional","affiliation":[{"name":"UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences SUNY at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Adams","sequence":"additional","affiliation":[{"name":"Adams Sports Medicine Consulting LLC  Colorado Springs Colorado USA"},{"name":"Department of Kinesiology University of North Carolina at Greensboro  Greensboro North Carolina USA"},{"name":"School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine Loughborough University  Loughborough UK"},{"name":"Department of Kinesiology Michigan State University  East Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheri","family":"Blauwet","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Spaulding Rehabilitation\/Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantel T.","family":"Debert","sequence":"additional","affiliation":[{"name":"Hotchkiss Brain Institute University of Calgary  Calgary Alberta Canada"},{"name":"Integrated Concussion Research Program University of Calgary  Calgary Alberta Canada"},{"name":"Alberta Children's Hospital Research Institute University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn A.","family":"Emery","sequence":"additional","affiliation":[{"name":"Sport Injury Prevention Research Centre, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Human Performance Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"Hotchkiss Brain Institute University of Calgary  Calgary Alberta Canada"},{"name":"Integrated Concussion Research Program University of Calgary  Calgary Alberta Canada"},{"name":"Alberta Children's Hospital Research Institute University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"H976","DOI":"10.1152\/ajpheart.00639.2006","article-title":"Alterations in cerebral autoregulation and cerebral blood flow velocity during acute hypoxia: Rest and exercise","volume":"292","author":"Ainslie P. 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M.","year":"1986","journal-title":"The Lancet"},{"issue":"5","key":"e_1_2_9_6_1","first-page":"377","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg G. A.","year":"1982","journal-title":"Medicine and Science in Sports and Exercise"},{"issue":"11","key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1139\/apnm-2024-0028","article-title":"Does exercise modality and posture influence cerebrovascular and cardiovascular systems similarly?","volume":"49","author":"Burkart J. J.","year":"2024","journal-title":"Applied Physiology, Nutrition, and Metabolism"},{"issue":"10","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1139\/apnm-2019-0810","article-title":"Effects of high\u2010intensity intervals and moderate\u2010intensity exercise on baroreceptor sensitivity and heart rate variability during recovery","volume":"45","author":"Burma J. 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G.","year":"2013","journal-title":"British Journal of Sports Medicine"},{"issue":"10","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0224092","article-title":"Exercise intensity\u2010dependent effects of arm and leg\u2010cycling on cognitive performance","volume":"14","author":"Hill M.","year":"2019","journal-title":"PLoS ONE"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","DOI":"10.2196\/45321","article-title":"A Continuous Aerobic Resistance Exercise Protocol for Concussion Rehabilitation Delivered Remotely via a Mobile App: Feasibility Study","volume":"7","author":"Hutchison M. 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E.","year":"2023","journal-title":"Physiological Measurement"},{"issue":"2","key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A guideline of selecting and reporting intraclass correlation coefficients for reliability research","volume":"15","author":"Koo T. K.","year":"2016","journal-title":"Journal of Chiropractic Medicine"},{"key":"e_1_2_9_24_1","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyg.2013.00863","article-title":"Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t\u2010tests and ANOVAs","volume":"4","author":"Lakens D.","year":"2013","journal-title":"Frontiers in Psychology"},{"issue":"13","key":"e_1_2_9_25_1","doi-asserted-by":"crossref","first-page":"4492","DOI":"10.3390\/s21134492","article-title":"Internal consistency of sway measures via embedded head\u2010mounted accelerometers: implications for neuromotor investigations","volume":"21","author":"Lapointe A. 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S.","year":"2023","journal-title":"British Journal of Sports Medicine"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/13854046.2025.2492689"},{"issue":"5","key":"e_1_2_9_41_1","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1136\/bjsports-2015-094978","article-title":"The incidence of concussion in youth sports: A systematic review and meta\u2010analysis","volume":"50","author":"Pfister T.","year":"2016","journal-title":"British Journal of Sports Medicine"},{"key":"e_1_2_9_42_1","first-page":"1","volume-title":"Multilevel and longitudinal modeling using stata. volume i: continuous responses","author":"Rabe\u2010Hesketh S.","year":"2022"},{"issue":"1","key":"e_1_2_9_43_1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1177\/03635465030310011901","article-title":"Injury rates and profiles in female ice hockey players","volume":"31","author":"Schick D. 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