Sedentary behavior modifies the effect of balance rehabilitation on balance discordance in Parkinson’s disease

Abstract Individuals with Parkinson’s disease (PD) often experience a misalignment between their perceived and actual balance ability, known as balance discordance, which has been associated with falls. We examined whether high-intensity balance and gait training (HiBalance) alters balance discordance in individuals with PD, and whether baseline sedentary behavior influences these changes. A secondary analysis examining pre- to post-intervention discordance changes of two HiBalance clinical trials ( N = 97) using linear regression with interactions between sedentary behavior and pre-intervention discordance. The sample included two cohorts: one clinical and one research based. The model including sedentary behavior and its interaction with pre-intervention discordance explained 49% of variance. Significant predictors of post-intervention discordance were pre-intervention discordance (β = 8.78, p < 0.001) and cohort (β = 8.82, p = 0.006), while the interaction between pre-intervention discordance and sedentary time did not reach significance (β = −2.64, p = 0.05). Sensitivity analyses revealed that the clinical-based cohort model explained 24.7% of the variance in post-intervention discordance, with the interaction between pre-intervention discordance and sedentary time (β = −7.23, p = 0.004) as a significant predictor. HiBalance training did not significantly alter balance discordance. However, pre-intervention sedentary behavior may influence how much individuals with PD recalibrate the relationship between perceived and actual balance following physical rehabilitation.