CARE-ing for Concussions: Development of the Calgary Adapted aRm Ergometer (CARE) Test: A Novel Upper-Body Post-Concussion Exertion Test

Aerobic exercise following concussion is safe, effective, and improves recovery outcomes. Current research examining the relationship between post-concussion exercise and clinical recovery has largely focused on non-disabled athletes who can perform lower body aerobic exercise. For these athletes, post-concussion exercise protocols currently exist and are commonly performed in clinical settings such as the Buffalo Concussion Treadmill Test, Buffalo Concussion Bike Test and the Calgary Concussion Cycle Test (CCCT). However, all of these exertion tests are focused on exercise performed with the lower body and there currently does not exist an upper body specific post-concussion exertion protocol to help inform recovery recommendations. To address the need for more equitable and inclusive concussion research, this research developed a novel arm crank exercise protocol; the Calgary Adapted aRm Ergometer (CARE) post-concussion exertion test and compared its physiological utility as a post- concussion exertion test with the CCCT. Physiological data were collected on 20 non-disabled adult participants and 30 non-disabled adolescent participants who performed both the CARE and CCCT to volitional fatigue. Study findings support the use of the CARE test protocol, demonstrating robust physiological response profiles and moderate comparability with the CCCT. This level of comparability was expected given the smaller active muscle mass recruited during arm crank compared to cycle ergometry and participants limited familiarity with arm crank exercise performed to volitional fatigue. Overall, these findings help inform the safe and effective concussion rehabilitation process for underrepresented populations, promoting equity and inclusivity in sport injury and recovery research. This project fills a critical gap in concussion research, providing an inclusive and accessible alternative to lower-body specific exertion tests which cannot be performed by everyone following concussion.

Name thesis:degree_name

Master of Science (MSc)

Discipline thesis:degree_discipline

Kinesiology

Grantor

Kinesiology

Year dc:date.issued

2026

Author dc:creator

• Burkart, Joshua James

Advisors dc:contributor.advisor

• Smirl, Jonathan
• Emery, Carolyn

Committee members dc:contributor.committeemember

• Debert, Chantel
• Leddy, John
• Teel, Elizabeth

• concussion
• sport related concussion
• exertion testing
• exercise physiology
• cerebral blood flow
• traumatic brain injury

Statement dc:rights

• Unless otherwise indicated, this material is protected by copyright and has been made available with authorization from the copyright owner. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.

Language dc:language.iso

en

DOI

https://dx.doi.org/10.11575/PRISM/51035

OAI identifier oai:identifier

oai:ucalgary.scholaris.ca:1880/124019