Table 4.

Intervention participant (person living with MCI) and PT identified barriers to the balance yourself intervention

Sub-themes	Intervention participant (person living with MCI) quotes
Other commitments	My daughter-in-law and two children arrived from Africa to stay here and it’s been pretty flat out with them (ID27)
	Umm… probably busy in other areas you know – out in the garden or something and you don’t always feel like doing it when you come back in (ID42)
Felt unsafe	The ones which I had to close my eyes I didn’t like doing on my own. When I had somebody here I was happy to do it, but when you are on your own and you’ve got to… if you were to fall and you’ve got your eyes closed and you’re sort of like trying to pull yourself to save yourself from falling or something (ID01)
	It frightened me a little bit, yeah (ID56)
Did not see value/change	When I do that, I don’t seem to find any advantage to it (ID22)
	The end result wasn’t really, sorry, the end of the course wasn’t really productive in terms of improving (ID29)
Preferred other physical activity	Probably because I just do a lot of things outside; I do a lot of walking; I do things in the pool; I do a lot of things; I’m probably not really an indoor person (ID30)
Other health issues	I was just so tired all the time (ID56)
	I’m trying not to let it limit me. If it gets too painful then I will have some tablets, some drugs, but it’s not going to stop me from doing the things I want to do (ID56)

Sub-themes	PT quotes
The physical book	Yeah, it got lost and was under a pile of other papers or in a cupboard somewhere even though I told them leave it out; leave it on your table because when it’s on your table it reminds you of doing your exercises. If you put it in the cupboard you forget about it. And I tried to give all these instructions or ideas, but it just got lost (PT1)
	Yeah, and often they don’t remember. The biggest challenge is that they do not document on the book; they get either confused with the boxes and they think it’s how many times they have to do it. And if they don’t understand it’s the seconds, then they don’t actually cross it off. So when I go back and see them for a home visit, I couldn’t really adequately tell if they have actually done those exercises or not (PT3)
	I felt that they thought it was harder than the app in that the app could go everywhere with them. And I know some clients put their book in the drawer or they put the book on a table and then something would get put on top of it, so they were forgetting to use that more than they were the app (PT4)
Not the right challenge	The difficulty where most of my clients were struggling was tandem – one foot in front of the other and then turning head up/down or left and right and eyes closed. That’s where most of the time I started with the exercises because that was challenging. And the one that was in the book before was too easy, so most of the time I started with that one tandem eyes open and then tandem left and right, tandem up and down, and then eyes closed. So I stuck around that exercise quite a bit and I had a few that were able to do single leg but I wasn’t surprised that they were able to do it because they were generally quite fit and active (PT1)
	I’d always say to them this will take you about six to eight weeks to get right, but it was still frustrating for them (PT3)
Hard to gauge improvements	Yeah, I got stuck with the book exercises quite a bit. The first few times I came and assessed - Ok, let’s start with either one and see how you go and it was too easy. Let’s go to the next one – oh, that’s too easy; Let’s go to the next one, so I found an exercise that’s challenging but not dangerous, so we got to that point and a lot of the times they were stuck around that exercise and when I came back they hadn’t progressed a lot (PT1)
	All I can do is make them do the exercises and see how they are performing and, based on that, maybe go like ok they might have practised, but often they do not use the book how they should be using it as in ticking off the boxes, putting the date on completed and moving to the second page. Often it’s unwritten, undocumented (PT2)
More advanced cognitive impairment	But the main fact is actually that it’s not suitable for people that have cognitive issues (PT2)
	So one of my ladies, you know how you’d have to do something for 30 seconds and put a date, she’d do one exercise, count to 30 and then tick if off and then she wouldn’t return back to that exercise at all. So she’d go through as far as she could and then she got stuck on one exercise. Then when she got stuck she got very upset because she couldn’t get to the 30 in that one go and didn’t understand the concept of just practice and you can practice five or six different exercises and you know, if you got to 20 that’s ok, but when you get to 30 you need to write the date down (PT4)

Sub-themes	Intervention participant (person living with MCI) and PT quotes
Too difficult	Yeah. When it comes to things like that that I know are difficult, I avoid that (ID22)
	These ones I had a lot of difficulty with, so they didn’t result in me getting better, they just got to a plateau …. I lost interest because I was unsuccessful doing it (ID29)
	I think a lot of the clients found some of it difficult to understand (PT4)
	People said it wasn’t as “user friendly” (PT4)
Lack of motivation/laziness	For a while and then I got a bit bored with it (ID10)
	Well, I think I already said I wasn’t very motivated and I found them quite boring (ID30)
	You have to be driven enough to want to get to the 30 seconds, you have to concentrate, you have to really understand how your body has to work to position yourself and support yourself in that position (PT2)