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Background: Very young children from lower socioeconomic status (SES) backgrounds often show poorer language development. Whilst there have been attempts to provide early intervention programmes, these sometimes miss the most disadvantaged groups. Aims: This report presents preliminary feasibility and effectiveness data for a novel language intervention designed for parents of toddlers in the United Kingdom. Methods and Procedures: In total, 43 UK families of 2–4‐year‐olds were recruited to the study, half of whom completed an 8‐week course (Tots Talking) focussed on parent interaction, and half of whom acted as wait‐list controls. Results and Outcomes: Results suggest that such programmes are feasible for families with 86% staying in the intervention. In addition, greater changes in underlying communication skills such as joint attention and gesture were evident compared to wait‐list controls. Conclusions and Implications: We conclude that pre‐verbal skills may be more important to measure as initial outcomes than language or vocabulary change in this population. What This Paper Adds: What is already known on the subject: Children from lower socioeconomic status (SES) backgrounds are at higher risk of communication difficulties and there is a need for community intervention programmes for very young children. What this study adds: This study suggests that such programmes can be feasible and effective, but that very early/basic communicative skills (such as joint attention) may be boosted first rather than language or vocabulary. What are the clinical implications of this work?: Children's centres and other community services could feasibly run short parent facing courses emphasising contingent communication in low SES families and other diverse groups. These may be more successful run with younger preschoolers. Joint attention may be a better focus of intervention before expecting vocabulary or language change. Community health professionals may find this information useful in referring and supporting families in need. [ABSTRACT FROM AUTHOR]

Background: A total of 68% of pre‐school children with cleft palate have speech problems requiring speech therapy. There is a lack of access to regular targeted therapy. Parent training leads to positive outcomes in early communication skills in cleft palate and non‐cleft speech disorders. Connected health has been used to address inadequate access to therapy, providing intervention to those who would not otherwise receive therapy. Aims: To evaluate the speech, activity and participation outcomes of Parent Led, Therapist Supervised, Articulation Therapy (PLAT) compared with routine speech therapy intervention in parent–child dyads. Methods & Procedures: A total of 44 children, aged 2.9–7.5 years, were included in a two‐centre, two‐phase randomized controlled trial. Informed consent and assent were obtained. Participants and speech and language therapists (SLTs) were unblinded to the groups. Parents, in the parent‐trained group (n = 23), attended 2 days' training, received a detailed speech therapy programme, and undertook intervention over 12 weeks supported by the cleft specialist SLT using FaceTime and one face‐to‐face session. In the control arm (n = 21), parent–child dyads received six therapy sessions over 12 weeks with a research SLT, comparable with usual care. Speech recordings were undertaken pre‐ and post‐intervention. Percent consonant correct (PCC) was analysed by external SLTs blinded to the time and group. Activity and participation were measured using the Intelligibility in Context Scale (ICS) and Focus on Outcomes for Children Under Six (FOCUS) questionnaire. Outcomes & Results: There was no evidence of an interaction between Time and Group or an overall statistical difference between groups for PCC scores. There was a statistically significant difference over time for both groups (words: p < 0.002; confidence interval (CI) = 9.38–16.27; d = 0.57; sentences: p < 0.002; CI = 16.04–25.97; d = 0.23). Effect sizes were medium for words and small for sentences. For intelligibility and participation, there was no evidence of an interaction between Time and Group or an overall statistical difference between groups. A statistically significant difference over time was found for intelligibility (F = 29.97, d.f. = 1, 42, p < 0.001, 95 % CI = 1.45–3.15 d = 0.46) and for participation (F = 14.19, d.f. = 1, 41, p < 0.001 95% CI = 7.63–25.03; d = 0.36) with FOCUS results indicating clinically meaningful (parent‐led group) and significant (control group) change in participation. Conclusions & Implications: PLAT can be as effective as routine care in changing speech, activity and participation outcomes for children with cleft palate, when supported by a specialist cleft SLT using connected health. What this paper addsWhat is already known on this subjectOver 50% of children with cleft palate require speech therapy. However, there is a lack of timely, accessible speech therapy services in the UK and Ireland. Previous studies have shown that parents can deliver therapy effectively, and that connected health can support the delivery of speech therapy. This study aims to provide evidence that parent‐led therapy with the supervision of a specialist cleft therapist using FaceTime is effective.What this paper adds to existing knowledgeThis randomized controlled trial indicates that parents can be trained to deliver therapy for children with cleft palate speech disorders, under the supervision of an SLT. This approach results in improved speech, activity and participation outcomes similar to routine care.What are the potential or actual clinical implications of this work?This study indicates that both parent‐led articulation therapy and routine care showed meaningful gains in speech, activity and participation, and that parent‐led articulation therapy when supported by a cleft SLT using connected health could be an additional service delivery model for children with cleft palate speech disorders. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the cardiometabolic and physical effects of 2 timematched high-intensity programs in a real-world environment. Forty-three active and healthy adults (sex =31 men and 12 women; age = 27 + 5 years; peak heart rate [HRpeak] = 190.7 + 10.6 beat·min-1) were randomized to 2 very low-volume protocols (;8 minutes): sprint interval training (SIT) (n=15), burpee interval training (BIT) (n=15), and control (CON) (n=13). Subjects in SIT and BIT performed 5 days of 10 3 4 second "all-out" efforts with 30 seconds of recovery. Body composition, blood pressure, countermovement jump (CMJ), 10-m sprint, shuttle run test (SRT), autonomic modulation, self-efficacy, and intention were evaluated before and after training. Sprint interval training elicited a higher %HRpeak, energy expenditure, rating of perceived exertion category ratio 10 scale, and feeling scale than BIT (p, 0.05). SRTdistance was significantly improved in SIT (p = 0.03, d = 0.62), whereas CMJ height was significantly enhanced in BIT (p=0.0014, d=0.72). Self-efficacy progressively worsened for SIT than for BIT as sessions increased, and significant differences were found in 5X week frequency between protocols (p=0.040, d50.79). No differences in intention to engage were detected between the regimens (p. 0.05). No changes were observed in body composition, blood pressure, 10-m sprint, SRTV-O2max, or autonomic variables with training (p. 0.05). Results exhibit that extremely low-volume SIT improved running performance, whereas BIT increased the vertical jump. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of multidirectional elastic tape on pain and function in individuals with lateral elbow tendinopathy. Study Design: Randomised crossover trial. Setting: Biomechanics laboratory. Subjects: 27 participants (11 females, mean (SD) age: 48.6 (11.9) years) with clinically diagnosed lateral elbow tendinopathy of at least six weeks' duration. Interventions: Tensioned multidirectional elastic tape applied over the wrist, compared to control tape (untensioned), and no tape conditions. Main measures: Pain-free grip strength and pressure pain threshold were recorded at three timepoints for each condition: baseline, post-application, and following an exercise circuit. Change scores were calculated as the post-application or post-exercise value minus baseline. Repeated-measure analyses of variance were used to examine differences between conditions. Results: There were no statistically significant differences in pain-free grip strength between conditions (flexed position: F2,52 = 0.02, p = 0.98; extended position: F2,52 = 2.26, p = 0.12) or across timepoints (post-application vs post-exercise) (flexed position: F1,26 = 0.94, p = 0.34; extended position: F1,26 = 0.79, p = 0.38). Seven participants (26%) increased pain-free grip strength above the minimal detectable change following application of multidirectional elastic tape. There were no statistically significant differences in pressure pain threshold between conditions (affected lateral epicondyle: F1.51,39.17 = 0.54, p = 0.54) or across timepoints (affected lateral epicondyle: F1,26 = 0.94, p = 0.34). Conclusion: Tensioned multidirectional elastic tape may not immediately improve pain-free grip strength or pressure pain threshold in our lateral elbow tendinopathy population; however, individual variation may exist. [ABSTRACT FROM AUTHOR]

This study aims to compare the effectiveness of uphill walking and physical therapy versus physical therapy alone on knee pain, excursion ranges, stride length, and walking speed in individuals with knee osteoarthritis. In this randomized clinical trial, 30 patients with knee osteoarthritis participated. Both control and intervention groups received 10-session physical therapy. Moreover, the intervention group received an 8-degree treadmill walking at a speed of 1.1 m/s for 30 min in each session. Outcome measures, including pain, excursion ranges, stride length, and walking speed, were measured at baseline, post-treatment, and a 20-day follow-up. Significant improvements in stride length and walking speed were observed just in the intervention group from baseline to post-treatment (p ≤ 0.001) and from baseline to follow-up (p ≤ 0.001). Furthermore, significant improvement in excursion ranges was observed just in the intervention group from baseline to follow-up (p < 0.05). This study revealed that the addition of uphill walking to physical therapy results in stride length and walking speed improvements and that it also has persistent effects on knee ranges, stride length, and walking speed as compared with physical therapy alone. This clinical trial was registered at irct.ir (study ID: IRCT20171115034920N1). Stretching exercises are recommended to correct knee flexion contracture and uphill treadmill walking is a form of functional stretching. This study shows 10 sessions of combined uphill treadmill walking and physical therapy provided superior improvements in stride length and walking speed at 10-session or 20-day follow-up, and active and passive excursion ranges at 20-day follow-up compared with physical therapy alone. Physical therapist may consider uphill treadmill walking when designing a physical therapy for patients with knee osteoarthritis to promote the results of the rehabilitation programs. [ABSTRACT FROM AUTHOR]

We aimed to determine the gains in explosive movements of male junior soccer players induced by incorporating an 8-week plyometric training program (PTP) into a standard soccer conditioning regimen 5 months after the beginning of the competitive season. Our hypothesis was that PTP would enhance explosive movements, and thus sprint running, repeated shuttle sprint ability (RSSA), agility and the ability to make repeated changes of direction (RCOD). A group of junior soccer players were randomly divided into 2 groups: an experimental group (E, n = 15, age 15.7 ± 0.2 years) and a control group (C, n = 13, age 15.8 ± 0.2 years). The participants in E and C performed training exercises and matches together, but for an 8-week period in the latter part of the season, the experimental group replaced a part of the normal regimen (the tactical session) by a biweekly course of PTP (hurdle and drop jumps). Two familiarization sessions were held 2 weeks before definitive testing. The ability of the players was assessed by 3 agility tests (a sprint test with 1808 turns, a 9-3-6-3-9 m sprint with backward and forward running, and a four 5-m sprint test with turns); 2 repeated sprint tests (RSSA and RCOD); and running times over 5-, 1 0-, 20-, 30-, and 40-m distances. Participants in E showed gains relative to C in sprint times (p ≤ 0.05 for 5, 1 0, and 20 m), and 2 of 3 the RCOD parameters (RCOD best, p ≤ 0.001 ; RCOD total, p ≤ 0.05). However, with the pattern of plyometric training that we adopted, and perhaps because participants were in good initial physical condition, the agility and RSSA test scores remained unchanged. Nevertheless, we conclude that our PTP can be commended to junior soccer players as a means of improving important components of their physical performance. [ABSTRACT FROM AUTHOR]

This pilot RCT compared the effect of a self-directed and therapist-assisted telehealth-based parent-mediated intervention for young children with ASD. Families were randomly assigned to a self-directed or therapist-assisted program. Parents in both groups improved their intervention fidelity, self-efficacy, stress, and positive perceptions of their child; however, the therapist-assisted group had greater gains in parent fidelity and positive perceptions of child. Children in both groups improved on language measures, with a trend towards greater gains during a parent-child interaction for the therapist-assisted group. Only the children in the therapist-assisted group improved in social skills. Both models show promise for delivering parent-mediated intervention; however, therapist assistance provided an added benefit for some outcomes. A full-scale comparative efficacy trial is warranted. [ABSTRACT FROM AUTHOR]