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The Calgary Adapted aRm Ergometer (CARE) test, developed as the first upper\u2010body specific exertion test, aims to improve accessibility and inclusivity in concussion care. While initial development was conducted in adults, its applicability in adolescents remains unknown. This study compared physiological responses between the CARE test and the Calgary Concussion Cycle Test (CCCT) in non\u2010disabled adolescent male and female athletes. Fifteen females and fifteen males (aged 14\u201317) performed CARE and CCCT to volitional fatigue. Response differences, Bland\u2013Altman plots, effect sizes, intraclass correlation and moderation by sex for heart rate (HR), middle cerebral artery velocity (MCAv), volume of oxygen consumption (), minute ventilation () and end\u2010tidal carbon dioxide () were analysed at 25%, 50%, 75% and 100% of peak exertion levels. CARE elicited lower absolute values for HR, MCAv, ,  and  compared to CCCT, with differences and 95% limits\u2010of\u2010agreement becoming more pronounced at higher intensities. For mild\u2010to\u2010moderate exercise (25\u201350% exertion), the range typically used in clinical concussion testing, HR and MCAv differences were small for both sexes. Near maximal intensity, the HR gap widened, but MCAv was comparable. Sex did not modify the relationship between tests for HR and MCAv. While CARE predominantly employs smaller muscle mass than CCCT, results showed robust and relatively comparable physiological responses between tests and between male and female adolescents. These findings further support CARE as an accessible and inclusive post\u2010concussion exertion test for those not able to perform lower\u2010body protocols.<\/jats:p>","DOI":"10.1113\/ep093264","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T22:45:18Z","timestamp":1783637118000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physiological evaluation of the Calgary adapted aRm ergometer (CARE) concussion exertion test in adolescent athletes: A repeated\u2010measures observational study"],"prefix":"10.1113","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2142-7669","authenticated-orcid":false,"given":"Joshua J.","family":"Burkart","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\/0009-0000-5397-208X","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 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School of Medicine 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 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