Feasibility and Safety of a Powered Exoskeleton for Balance Training for People Living with Multiple Sclerosis: A Single-Group Preliminary Study (Rapper III).

This was a single-arm preliminary study with no control group, so the exoskeleton cannot be separated from the exercise programme delivered within it. Only 11 participants were enrolled and 10 completed, which is too small to establish treatment efficacy. Participants varied widely from walking independently with a stick to needing a hoist for transfers, making group patterns hard to interpret. Many secondary outcomes were tested, and the authors noted that some changes could have occurred by chance. The intervention was limited to four sessions because of resources, so the dose needed for benefit is unknown. Screening excluded many potential participants for device fit, especially calf muscle bulk exceeding 375 mm, so results apply only to people who can physically fit the device. All participants were White, so applicability to other populations is not established. One participant withdrew after a multiple sclerosis relapse, which is common in relapsing remitting MS and not necessarily caused by the trial.

The supplied text does not include a funding or conflict-of-interest declaration. It identifies the Rex Bionics Ltd exoskeleton and lists NIHR and NHS Trust registration references, but it does not state who funded the study or whether authors declared competing interests.

Do not read the improvements in balance, MS impact or quality of life as proof that the exoskeleton works. This was a single-group study with no control group, and the authors noted that multiple secondary outcomes could have changed by chance.