Paul Gordon | Baylor University (original) (raw)
Papers by Paul Gordon
Obesity Reviews, Oct 23, 2012
Premature declines in function among adults with cerebral palsy (CP) are generally attributed to ... more Premature declines in function among adults with cerebral palsy (CP) are generally attributed to weakness, spasticity and orthopaedic abnormalities, as well as chronic pain and fatigue. Very little research or clinical attention has been devoted to the confluence and consequences of early muscle wasting and obesity as mediators of secondary comorbidity in this population, and perhaps more importantly, to the role of lifestyle to potentiate these outcomes. At present, there are no national surveillance programmes that monitor chronic health in adults with CP; however, mortality records have demonstrated a greater prevalence of coronary heart disease as compared with the general population. Although by definition, CP is a 'non-progressive' condition, secondary factors such as habitual sedentary behaviour, obesity, and premature sarcoepenia may increase the severity of functional impairment throughout adulthood, and lead to cardiometabolic disease, fragility and/or early mortality. Herein we describe the heightened health risk represented in adults with CP, and discuss the hallmark phenotypic features that coincide with ageing, obesity and cardiometabolic disorders. Moreover, we provide discussion regarding the protective role of habitual physical activity to stimulate anti-inflammatory pathways and to ameliorate global risk. Although physical therapeutic modalities are already widely acknowledged as a vital component to improve movement quality in CP, the purpose of this review was to present a compelling case for the value of lifelong physical activity participation for both function and cardiometabolic health preservation.
The FASEB Journal, Apr 1, 2013
Medicine and Science in Sports and Exercise, May 1, 1993
Medicine and Science in Sports and Exercise, Apr 1, 1990
American Journal of Preventive Medicine, May 1, 2016
There is an association between strength and health among adolescents, yet, what remains to be de... more There is an association between strength and health among adolescents, yet, what remains to be determined is sex-specific cut points for low strength in the detection of risk in this population. The purpose of this study was to determine thresholds of low grip strength in a large cohort (N=1,326) of adolescents. All data were collected between 2005 and 2008, and analyzed in 2014-2015. A cardiometabolic risk score (MetScore) was computed from the following components: percent body fat, fasting glucose, blood pressure, plasma triglyceride levels, and high-density lipoprotein cholesterol. A high-risk cardiometabolic phenotype was characterized as ≥75th percentile of the MetScore. Conditional inference tree analyses were used to identify sex-specific, low normalized strength (grip strength/body mass) thresholds and risk categories. Lower strength was independently associated with increased odds of the high-risk cardiometabolic phenotype, such that for every 5% decrement of normalized strength, there were 1.48 and 1.45 increased odds (p<0.001) for boys and girls, even after adjusting for cardiorespiratory fitness and physical activity. Conditional tree analysis revealed a high-risk threshold for boys (≤0.33) and girls (≤0.28), as well as an intermediate threshold (boys, >0.33 and ≤0.45; girls, >0.28 and ≤0.36). These sex-specific thresholds of low strength can be incorporated into a clinical setting for identifying adolescents that would benefit from lifestyle interventions to improve muscular fitness and reduce cardiometabolic risk.
Medicine and Science in Sports and Exercise, May 1, 1993
Medicine and Science in Sports and Exercise, May 1, 2017
Medicine and Science in Sports and Exercise, May 1, 1992
Medicine and Science in Sports and Exercise, May 1, 1996
Medicine and Science in Sports and Exercise, May 1, 2003
British Journal of Sports Medicine, Mar 1, 1998
Increases in high density lipoprotein cholesterol (HDL-C) levels have previously been reported af... more Increases in high density lipoprotein cholesterol (HDL-C) levels have previously been reported after moderate exercise bouts lasting less than two hours in men. Little information exists, however, on HDL-C responses after moderate duration exercise in women. Post-exercise HDL-C modifications may appear diVerently in women because of higher baseline HDL-C concentrations and diVerences in lipolytic activity. To determine the influence of exercise on acute HDL-C responses in women, 12 trained premenopausal women (22 (4) years old; mean (SD)) who ran 24-48 km a week exercised on a motor driven treadmill at 75% VO 2 MAX until 3.34 MJ (800 kcal) were expended (72 (9) min). Subjects were all tested during the early follicular phase of their menstrual cycle. Fasting blood samples were obtained before exercise (baseline), immediately after (IPE), one hour after (1 h PE), 24 hours after (24 h PE), and 48 hours after (48 h PE) exercise. Plasma was analysed for HDL-C, HDL 2-C, and HDL 3-C. A significant increase in HDL-C was observed 48 h PE (p<0.05). HDL 3-C increased IPE (p<0.01) but returned to baseline at 1 h PE. In contrast, HDL 2-C was not significantly diVerent from baseline at any time point. The rise in HDL-C, however, was attributed to an increase in both HDL 2 and HDL 3. Moreover, at 48 h PE, the increase in HDL-C correlated highly with changes in HDL 2-C (r = 0.92). Thus it appears that exercise of moderate duration can elicit similar post-exercise increases in HDL-C in women to those previously reported in men. However, the changes in HDL subfractions leading to the rise in HDL-C may be diVerent in women.
Background: Traditional thinking is that physical activity benefits mental and physical health, h... more Background: Traditional thinking is that physical activity benefits mental and physical health, however, excessive physical activity can increase anxiety, depression, and affect the gut microbiome. Considering the strong connection between the gut and the brain, the purpose of the present study was to evaluate the association between gut microbiota composition and anxiety as well as depression in highly active individuals. Methods: Participants included 55 young adults (ages 18-25, 51% males). All participants were highly physically active, as determined by 7 days of SenseWear monitoring. Anxiety and depression were measured with the Beck Anxiety and Depression Inventories. Alpha diversity, beta diversity, and microbial composition were evaluated via 16S rRNA gene sequencing using distal gut samples. Results: Greater anxiety was associated with both lower distal gut alpha diversity ( P < 0.05) and higher beta diversity (PERMANOVA test; R-squared: 0.17562, P = 0.027), which appear...
Medicine & Science in Sports & Exercise, 1995
Medicine & Science in Sports & Exercise, 2011
Purpose-Sarcopenia plays a principal role in the pathogenesis of frailty and functional impairmen... more Purpose-Sarcopenia plays a principal role in the pathogenesis of frailty and functional impairment that occurs with aging. There are few published accounts which examine the overall benefit of resistance exercise (RE) for lean body mass (LBM), while considering a continuum of dosage schemes and/or age ranges. Therefore the purpose of this meta-analysis was to determine the effects of RE on LBM in older men and women, while taking these factors into consideration. Methods-This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Randomized controlled trials and randomized or non-randomized studies among adults ≥ 50 years, were included. Heterogeneity between studies was assessed using the Cochran Q and I 2 statistics, and publication bias was evaluated through physical inspection of funnel plots as well as formal rank-correlation statistics. Mixed-effects metaregression was incorporated to assess the relationship between RE dosage and changes in LBM. Results-Data from forty-nine studies, representing a total of 1328 participants were pooled using random-effect models. Results demonstrated a positive effect for lean body mass and there was no evidence of publication bias. The Cochran Q statistic for heterogeneity was 497.8, which was significant (p < 0.01). Likewise, I 2 was equal to 84%, representing rejection of the null hypothesis of homogeneity. The weighted pooled estimate of mean lean body mass change was 1.1 kg (95% CI, 0.9 kg to 1.2 kg). Meta-regression revealed that higher volume interventions were associated (β = 0.05, p < 0.01) with significantly greater increases in lean body mass, whereas older individuals experienced less increase (β =-0.03, p = 0.01). Conclusions-RE is effective for eliciting gains in lean body mass among aging adults, particularly with higher volume programs. Findings suggest that RE participation earlier in life may provide superior effectiveness.
Medicine & Science in Sports & Exercise, 1992
Archives of Physical Medicine and Rehabilitation, 2013
Objective-To examine the feasibility and potential benefits of using recumbent cross-training for... more Objective-To examine the feasibility and potential benefits of using recumbent cross-training for nonambulatory adults with cerebral palsy (CP). Design-Observational. Setting-Clinical center for CP treatment and rehabilitation. Participants-Significantly motor-impaired adults with CP (NZ = 11) with a mean age ± SD of 36.3 ± 13.2 years and Gross Motor Function Classification System (GMFCS) III and IV. Interventions-Participants completed a 40-minute session of aerobic exercise using the NuStep Recumbent Cross Trainer, in which resistance was progressively increased at 5-minute intervals. Main Outcome Measures-Every 5 minutes during the exercise session, heart rate, blood pressure, oxygen consumption (), energy expenditure, and respiratory exchange ratios (RERs) were recorded along with rating of perceived exertion. Immediately after, and 24 hours postexercise, participants received a standard survey to assess levels of pain and discomfort. Results-All participants were able to complete the 40-minute exercise protocol. Five of the 11 participants achieved a heart rate of at least 60% maximum throughout the duration, 10 participants had a significant elevation in from baseline, and all participants had elevated
American Journal of Physiology-Endocrinology and Metabolism, 2012
Cerebral palsy (CP) is caused by an insult to or malformation of the developing brain which affec... more Cerebral palsy (CP) is caused by an insult to or malformation of the developing brain which affects motor control centers and causes alterations in growth, development, and overall health throughout the life span. In addition to the disruption in development caused by the primary neurological insult, CP is associated with exaggerated sedentary behaviors and a hallmark accelerated progression of muscle pathology compared with typically developing children and adults. Factors such as excess adipose tissue deposition and altered partitioning, insulin resistance, and chronic inflammation may increase the severity of muscle pathology throughout adulthood and lead to cardiometabolic disease risk and/or early mortality. We describe a model of exaggerated health risk represented in adults with CP and discuss the mechanisms and secondary consequences associated with chronic sedentary behavior, obesity, aging, and muscle spasticity. Moreover, we highlight novel evidence that implicates aberra...
Medicine & Science in Sports & Exercise, 1995
The FASEB Journal, Mar 1, 2006
Obesity Reviews, Oct 23, 2012
Premature declines in function among adults with cerebral palsy (CP) are generally attributed to ... more Premature declines in function among adults with cerebral palsy (CP) are generally attributed to weakness, spasticity and orthopaedic abnormalities, as well as chronic pain and fatigue. Very little research or clinical attention has been devoted to the confluence and consequences of early muscle wasting and obesity as mediators of secondary comorbidity in this population, and perhaps more importantly, to the role of lifestyle to potentiate these outcomes. At present, there are no national surveillance programmes that monitor chronic health in adults with CP; however, mortality records have demonstrated a greater prevalence of coronary heart disease as compared with the general population. Although by definition, CP is a 'non-progressive' condition, secondary factors such as habitual sedentary behaviour, obesity, and premature sarcoepenia may increase the severity of functional impairment throughout adulthood, and lead to cardiometabolic disease, fragility and/or early mortality. Herein we describe the heightened health risk represented in adults with CP, and discuss the hallmark phenotypic features that coincide with ageing, obesity and cardiometabolic disorders. Moreover, we provide discussion regarding the protective role of habitual physical activity to stimulate anti-inflammatory pathways and to ameliorate global risk. Although physical therapeutic modalities are already widely acknowledged as a vital component to improve movement quality in CP, the purpose of this review was to present a compelling case for the value of lifelong physical activity participation for both function and cardiometabolic health preservation.
The FASEB Journal, Apr 1, 2013
Medicine and Science in Sports and Exercise, May 1, 1993
Medicine and Science in Sports and Exercise, Apr 1, 1990
American Journal of Preventive Medicine, May 1, 2016
There is an association between strength and health among adolescents, yet, what remains to be de... more There is an association between strength and health among adolescents, yet, what remains to be determined is sex-specific cut points for low strength in the detection of risk in this population. The purpose of this study was to determine thresholds of low grip strength in a large cohort (N=1,326) of adolescents. All data were collected between 2005 and 2008, and analyzed in 2014-2015. A cardiometabolic risk score (MetScore) was computed from the following components: percent body fat, fasting glucose, blood pressure, plasma triglyceride levels, and high-density lipoprotein cholesterol. A high-risk cardiometabolic phenotype was characterized as ≥75th percentile of the MetScore. Conditional inference tree analyses were used to identify sex-specific, low normalized strength (grip strength/body mass) thresholds and risk categories. Lower strength was independently associated with increased odds of the high-risk cardiometabolic phenotype, such that for every 5% decrement of normalized strength, there were 1.48 and 1.45 increased odds (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) for boys and girls, even after adjusting for cardiorespiratory fitness and physical activity. Conditional tree analysis revealed a high-risk threshold for boys (≤0.33) and girls (≤0.28), as well as an intermediate threshold (boys, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.33 and ≤0.45; girls, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.28 and ≤0.36). These sex-specific thresholds of low strength can be incorporated into a clinical setting for identifying adolescents that would benefit from lifestyle interventions to improve muscular fitness and reduce cardiometabolic risk.
Medicine and Science in Sports and Exercise, May 1, 1993
Medicine and Science in Sports and Exercise, May 1, 2017
Medicine and Science in Sports and Exercise, May 1, 1992
Medicine and Science in Sports and Exercise, May 1, 1996
Medicine and Science in Sports and Exercise, May 1, 2003
British Journal of Sports Medicine, Mar 1, 1998
Increases in high density lipoprotein cholesterol (HDL-C) levels have previously been reported af... more Increases in high density lipoprotein cholesterol (HDL-C) levels have previously been reported after moderate exercise bouts lasting less than two hours in men. Little information exists, however, on HDL-C responses after moderate duration exercise in women. Post-exercise HDL-C modifications may appear diVerently in women because of higher baseline HDL-C concentrations and diVerences in lipolytic activity. To determine the influence of exercise on acute HDL-C responses in women, 12 trained premenopausal women (22 (4) years old; mean (SD)) who ran 24-48 km a week exercised on a motor driven treadmill at 75% VO 2 MAX until 3.34 MJ (800 kcal) were expended (72 (9) min). Subjects were all tested during the early follicular phase of their menstrual cycle. Fasting blood samples were obtained before exercise (baseline), immediately after (IPE), one hour after (1 h PE), 24 hours after (24 h PE), and 48 hours after (48 h PE) exercise. Plasma was analysed for HDL-C, HDL 2-C, and HDL 3-C. A significant increase in HDL-C was observed 48 h PE (p<0.05). HDL 3-C increased IPE (p<0.01) but returned to baseline at 1 h PE. In contrast, HDL 2-C was not significantly diVerent from baseline at any time point. The rise in HDL-C, however, was attributed to an increase in both HDL 2 and HDL 3. Moreover, at 48 h PE, the increase in HDL-C correlated highly with changes in HDL 2-C (r = 0.92). Thus it appears that exercise of moderate duration can elicit similar post-exercise increases in HDL-C in women to those previously reported in men. However, the changes in HDL subfractions leading to the rise in HDL-C may be diVerent in women.
Background: Traditional thinking is that physical activity benefits mental and physical health, h... more Background: Traditional thinking is that physical activity benefits mental and physical health, however, excessive physical activity can increase anxiety, depression, and affect the gut microbiome. Considering the strong connection between the gut and the brain, the purpose of the present study was to evaluate the association between gut microbiota composition and anxiety as well as depression in highly active individuals. Methods: Participants included 55 young adults (ages 18-25, 51% males). All participants were highly physically active, as determined by 7 days of SenseWear monitoring. Anxiety and depression were measured with the Beck Anxiety and Depression Inventories. Alpha diversity, beta diversity, and microbial composition were evaluated via 16S rRNA gene sequencing using distal gut samples. Results: Greater anxiety was associated with both lower distal gut alpha diversity ( P < 0.05) and higher beta diversity (PERMANOVA test; R-squared: 0.17562, P = 0.027), which appear...
Medicine & Science in Sports & Exercise, 1995
Medicine & Science in Sports & Exercise, 2011
Purpose-Sarcopenia plays a principal role in the pathogenesis of frailty and functional impairmen... more Purpose-Sarcopenia plays a principal role in the pathogenesis of frailty and functional impairment that occurs with aging. There are few published accounts which examine the overall benefit of resistance exercise (RE) for lean body mass (LBM), while considering a continuum of dosage schemes and/or age ranges. Therefore the purpose of this meta-analysis was to determine the effects of RE on LBM in older men and women, while taking these factors into consideration. Methods-This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Randomized controlled trials and randomized or non-randomized studies among adults ≥ 50 years, were included. Heterogeneity between studies was assessed using the Cochran Q and I 2 statistics, and publication bias was evaluated through physical inspection of funnel plots as well as formal rank-correlation statistics. Mixed-effects metaregression was incorporated to assess the relationship between RE dosage and changes in LBM. Results-Data from forty-nine studies, representing a total of 1328 participants were pooled using random-effect models. Results demonstrated a positive effect for lean body mass and there was no evidence of publication bias. The Cochran Q statistic for heterogeneity was 497.8, which was significant (p < 0.01). Likewise, I 2 was equal to 84%, representing rejection of the null hypothesis of homogeneity. The weighted pooled estimate of mean lean body mass change was 1.1 kg (95% CI, 0.9 kg to 1.2 kg). Meta-regression revealed that higher volume interventions were associated (β = 0.05, p < 0.01) with significantly greater increases in lean body mass, whereas older individuals experienced less increase (β =-0.03, p = 0.01). Conclusions-RE is effective for eliciting gains in lean body mass among aging adults, particularly with higher volume programs. Findings suggest that RE participation earlier in life may provide superior effectiveness.
Medicine & Science in Sports & Exercise, 1992
Archives of Physical Medicine and Rehabilitation, 2013
Objective-To examine the feasibility and potential benefits of using recumbent cross-training for... more Objective-To examine the feasibility and potential benefits of using recumbent cross-training for nonambulatory adults with cerebral palsy (CP). Design-Observational. Setting-Clinical center for CP treatment and rehabilitation. Participants-Significantly motor-impaired adults with CP (NZ = 11) with a mean age ± SD of 36.3 ± 13.2 years and Gross Motor Function Classification System (GMFCS) III and IV. Interventions-Participants completed a 40-minute session of aerobic exercise using the NuStep Recumbent Cross Trainer, in which resistance was progressively increased at 5-minute intervals. Main Outcome Measures-Every 5 minutes during the exercise session, heart rate, blood pressure, oxygen consumption (), energy expenditure, and respiratory exchange ratios (RERs) were recorded along with rating of perceived exertion. Immediately after, and 24 hours postexercise, participants received a standard survey to assess levels of pain and discomfort. Results-All participants were able to complete the 40-minute exercise protocol. Five of the 11 participants achieved a heart rate of at least 60% maximum throughout the duration, 10 participants had a significant elevation in from baseline, and all participants had elevated
American Journal of Physiology-Endocrinology and Metabolism, 2012
Cerebral palsy (CP) is caused by an insult to or malformation of the developing brain which affec... more Cerebral palsy (CP) is caused by an insult to or malformation of the developing brain which affects motor control centers and causes alterations in growth, development, and overall health throughout the life span. In addition to the disruption in development caused by the primary neurological insult, CP is associated with exaggerated sedentary behaviors and a hallmark accelerated progression of muscle pathology compared with typically developing children and adults. Factors such as excess adipose tissue deposition and altered partitioning, insulin resistance, and chronic inflammation may increase the severity of muscle pathology throughout adulthood and lead to cardiometabolic disease risk and/or early mortality. We describe a model of exaggerated health risk represented in adults with CP and discuss the mechanisms and secondary consequences associated with chronic sedentary behavior, obesity, aging, and muscle spasticity. Moreover, we highlight novel evidence that implicates aberra...
Medicine & Science in Sports & Exercise, 1995
The FASEB Journal, Mar 1, 2006