Performing Dynamic Weight-Shifting Balance Exercises With a Smartphone-Based Wearable Telerehabilitation System for Home Use by Individuals With Parkinson's Disease: A Proof-of-Concept Study

Telerehabilitation technology often helps individuals with Parkinson's disease (PD) to control their balance and improve postural stability. This proof-of-concept study describes the redesign of a smartphone-based wearable balance rehabilitation system, or Smarter Balance System (SBS) intended for in-home use, and determines the number of exercise sessions required to achieve steady-state balance exercise performance by people with PD who performed 6 weeks of in-home dynamic weight-shifting balance exercises. The redesigned SBS supplied real-time multimodal (visual and vibrotactile) biofeedback during dynamic weight-shifting balance exercises (WSBEs). A Technology Acceptance Model (TAM) questionnaire completed by participants validated its acceptability and use. The results of regression analyses of participants' balance exercise performance, based on the average cross-correlations and absolute position errors between the target motion and the exerciser's motion, showed exponential trends, a performance plateau after 3 weeks, and a quasi-steady state performance by the end of 6 consecutive weeks.