Objective: To determine the effectiveness of the adapted HiBalance program on balance control and gait among people with mild-moderate PD when performed in multiple clinical settings

Background: The HiBalance program was earlier shown to effectively improve balance control and gait in PD in a randomized controlled setting (1). Before implementation of this program in a clinical setting, we reduced the dose to a clinically feasbile one (20 hours of supervised group training) and added a home exercise program (2).

Methods: This study used a non-randomized controlled design. Participants (n=118) with mild-moderate PD were consecutively included into either the 10-week HiBalance training group (n=61) or to the control group (n=57). Participants were evaluated before and after the intervention (Spring 2016-Spring 2018). The main outcome was balance performance (Mini-BESTest). Secondary outcomes we will report are gait speed; physical activity level (average steps per day); balance confidence (Activities Specific Balance Confidence Scale); perceived walking difficulty (Walk-12G) and executive function (Trail making test B).

Results: In total, 98 people completed the trial (male/female ratio: 53/47%; mean age: 70 years; mean time since diagnosis: 7.3 years). At baseline, there was no significant difference in balance or gait function between the groups. Using a repeated measure mixed model analysis we found a significant interaction effect (p<.001) on balance control, where the training group improved with 2.2 MiniBESTest points (p<.005) compared to the control group (.94 points, p=.843). We also showed a significant interaction effect in gait speed among the training group (p<.005) compared to controls (P=.302).

Conclusions: The HiBalance program is shown to be clinically effective at improving balance control and gait in mild-moderate PD when delivered as a part of standard rehabilitation and given at a lower dose than previously tested. Upcoming analysis of other secondary outcomes will provide further evidence of the clinical applicability of this program.

References: 1. Conradsson D, Lofgren N, Nero H, et al. The Effects of Highly Challenging Balance Training in Elderly With Parkinson’s Disease: A Randomized Controlled Trial. Neurorehabilitation and neural repair. 2015;29(9):827-836. 2. Leavy B, Kwak L, Hagstromer M, Franzen E. Evaluation and implementation of highly challenging balance training in clinical practice for people with Parkinson’s disease: protocol for the HiBalance effectiveness-implementation trial. BMC neurology. 2017;17(1):27.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-effectiveness-of-a-highly-challenging-balance-training-hibalance-program-for-parkinsons-disease-a-multi-center-clinical-effectiveness-trial/