1. Introduction
Home-based rehabilitation programs for older adults have demonstrated effectiveness, desirability, and reduced burden. However, the feasibility and effectiveness of balance-intervention training delivered through traditional paper-versus novel smartphone-based methods is unknown. Therefore, the purpose of this study was to evaluate if a home-based balance-intervention program could equally improve balance performance when delivered via smartphone or paper among adults over the age of 65. A total of 31 older adults were randomized into either a paper or phone group and completed a 4-week asynchronous self-guided balance intervention across 12 sessions for approximately 30 min per session. Baseline, 4-week, and 8-week walking and standing balance evaluations were performed, with exercise duration and adherence recorded. Additional self-reported measures were collected regarding the enjoyment, usability, difficulty, and length of the exercise program. Twenty-nine participants completed the balance program and three assessments, with no group differences found for any outcome measure. Older adults demonstrated an approximately 0.06 m/s faster gait velocity and modified balance strategies during walking and standing conditions following the intervention protocol. Participants further self-reported similar enjoyment, difficulty, and exercise effectiveness. Results of this study demonstrated the potential to safely deliver home-based interventions as well as the feasibility and effectiveness of delivering balance intervention through a smartphone-based application.Aging is accompanied by deterioration in physical, cognitive, and psychological effects [Balance-intervention studies for older adults have demonstrated effectiveness in improving single- and dual-task balance performance [Therefore, the overall objective of this study was to evaluate if a home-based 4-week balance-intervention program could equally improve balance performance when delivered via smartphone or paper among older adults. We hypothesized that novel smartphone-delivered interventions could be successfully performed by older adults (based on compliance, fidelity, and the time required to complete home-based exercise programs), compared to traditional paper-based interventions. We further hypothesized that, regardless of the delivery method, all adults receiving intervention would demonstrate increased gait velocity and improved balance performance (i.e., greater dynamic stability as measured by the center of mass and base of support interaction as well as using appropriate postural strategies) under walking and standing conditions, respectively. Finally, we hypothesized that individuals would demonstrate a short-term retention effect, with increased gait velocity and standing balance up to 4-weeks post intervention.