Beetsterzwaag

Every year, many people in the Netherlands experience a stroke, with a significant number requiring rehabilitation due to lasting disabilities. This trial focuses on adults who have had a first-ever ischemic stroke or intracerebral hemorrhage resulting in weakness on one side of their upper limb. Researchers aim to evaluate the effectiveness and cost-effectiveness of continuous theta burst stimulation cTBS to improve arm function after stroke, building on earlier findings that showed promising recovery benefits. Participants will receive 10 daily sessions of cTBS treatment over two weeks, targeting the brain area controlling the unaffected arm side. This treatment is given immediately before regular physical therapy for the affected arm. The study compares active cTBS with a sham placebo version, using special coils to deliver the stimulation. The trial is double-blind and randomized, meaning neither patients nor researchers know which treatment is given until the study ends. During the study, participants arm function will be assessed using various tests at 90 days and one year after their stroke. These include the Fugl-Meyer Assessment, Action Research Arm Test, and others measuring hand use, daily activities, and quality of life. Researchers will also monitor medical care use and productivity costs. The study lasts up to one year, with evaluations designed to track recovery progress and treatment impact over time.

Children with cerebral palsy CP face challenges in walking due to motor impairments from early neurodevelopmental damage, affecting their ability to participate in physical and social activities. This can limit their overall development and well-being. Functional power training FPT, which combines high-velocity movements with resistance training, has emerged as a promising approach to improve walking ability, endurance, and participation compared to usual care or traditional strength training. This study aims to evaluate the effects of FPT, called MegaPower training, on personalized participation and activity goals in ambulant children with CP aged 4 to 12 years. The study compares two groups one receiving twelve weeks of MegaPower training with sessions three times a week guided by a personal trainer focusing on weighted functional exercises like walking, running, and stairs, combined with a personalized participation plan from a physiotherapist the other group receiving their usual care such as physiotherapy. After the initial 12-week period, both groups are followed up at 12 and 24 weeks to assess the lasting effects of the training. During follow-up, the control group also receives MegaPower training. Participants will attend visits at baseline, 12, 24, and 36 weeks to measure outcomes like achievement of participation goals, walking speed, aerobic and anaerobic capacity, physical activity, sleep, body composition, and self-perception. Researchers will track training implementation and explore which children benefit most from the program. The study includes various assessments using questionnaires, physical tests, and accelerometers to monitor progress and participation over time, ensuring comprehensive evaluation of the interventions impact.