June 10, 2026

@michaelokun

Can sitting too much change how you perceive your balance in Parkinson’s disease? Spoiler alert: Some folks underestimate their abilities and restrict activity, while others may overestimate their abilities and increase fall risk. Balance discordance refers to a mismatch between ‘how good’ folks think their balance is and ‘how good’ their balance actually is. Franziska Albrecht and colleagues describe in a new paper in npj Parkinson’s Disease how sedentary behavior may influence the effect of balance rehabilitation on balance discordance in Parkinson’s disease. Key points: - A highly challenging balance and gait training program improved balance performance however did not significantly change balance discordance across the entire study group. - Folks who were more sedentary before rehabilitation appeared more likely to improve the alignment between their perceived and actual balance abilities. - The findings suggest that physical rehabilitation alone may not be enough to recalibrate balance confidence and that psychological factors may also play an important role. My take: This paper reminds us that balance is not just about muscles and movement. It is also about perception. Some folks underestimate their abilities and restrict activity, while others may overestimate their abilities and increase fall risk. The future may require combining physical therapy, behavioral approaches and confidence building strategies to better align what the brain believes and what the body can do. Here are 5 points that resonated w/ me: 1- Parkinson’s disease can create a mismatch between actual balance ability and perceived balance confidence. 2- Simply improving physical performance may not automatically improve confidence or self-perception. 3- Sedentary individuals may have more room to recalibrate their understanding of their own abilities when exposed to challenging rehabilitation. 4- Fear of falling, anxiety and mood symptoms may influence balance confidence just as much as physical impairments. 5- The best rehabilitation programs of the future may target both the body and the brain by combining movement training w/ psychological strategies. https://www.nature.com/articles/