Supplemental Digital Content is Available in the Text. Background and Purpose: In order for people with Parkinson disease (PwPD) to benefit from neurorehabilitation research, interventions tested in research settings require assessment in real-world clinical practice. There is little evidence for whether efficacious exercise interventions for PwPD remain effective when transferred to standard clinical settings. The aim of this study was to assess the clinical effectiveness of the adapted HiBalance program on balance control and gait among PwPD. Methods: Participants (n = 117) with mild-moderate Parkinson disease were consecutively included into either the 10-week HiBalance group training (n = 61) or the control (n = 56) group. The main outcome was balance performance (Mini-BESTest). Secondary outcomes were comfortable gait speed (10-m Walk Test); functional mobility (Timed Up and Go [TUG] test) and dual-task interference (cognitive TUG test); physical activity level (steps per day); perceived balance confidence (Activities-specific Balance Confidence scale) and perceived walking difficulty (Walk-12G) and self-rated health (EQ-5D visual analog scale). Results: In total, 98 people completed the trial. Compared with controls, the training group showed significant improvement in balance performance (P < 0.001), gait speed (P = 0.001), and dual-task interference (P = 0.04) following the intervention. No group differences were observed for physical activity level or any patient-reported measures. Discussion and Conclusions: Highly challenging balance training is effective at improving balance, gait, and dual-task performance when delivered at a clinically feasible dose, in a range of rehabilitation settings, without direct involvement of the research group. Video Abstract available for more insights from the authors (see the Video, Supplementary Digital Content 1, available at: http://links.lww.com/JNPT/A299).

中文翻译：

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帕金森病患者高难度平衡训练的效果评估

补充数字内容在文本中可用。背景和目的：为了让帕金森病 (PwPD) 患者从神经康复研究中受益，在研究环境中测试的干预措施需要在现实世界的临床实践中进行评估。几乎没有证据表明有效的 PwPD 运动干预在转移到标准临床环境时是否仍然有效。本研究的目的是评估调整后的 HiBalance 计划对 PwPD 平衡控制和步态的临床有效性。方法：患有轻中度帕金森病的参与者 (n = 117) 被连续纳入 10 周 HiBalance 组训练 (n = 61) 或对照组 (n = 56)。主要结果是平衡性能（Mini-BESTest）。次要结果是舒适的步态速度（10 米步行测试）；功能移动性（Timed Up and Go [TUG] 测试）和双任务干扰（认知 TUG 测试）；身体活动水平（每天步数）；感知平衡信心（特定活动的平衡信心量表）和感知步行困难（Walk-12G）和自评健康（EQ-5D 视觉模拟量表）。结果：总共有98人完成了试验。与对照组相比，训练组在干预后平衡能力（P < 0.001）、步态速度（P = 0.001）和双任务干扰（P = 0.04）均有显着改善。没有观察到身体活动水平或任何患者报告的测量值的组间差异。讨论和结论：当以临床可行的剂量进行时，极具挑战性的平衡训练可有效改善平衡、步态和双任务表现，在一系列康复环境中，没有研究小组的直接参与。视频摘要可提供作者的更多见解（参见视频，补充数字内容 1，可在：http://links.lww.com/JNPT/A299 获得）。