Results of the First Interim Analysis of the RAPPER II Trial in Patients With Spinal Cord Injury: Ambulation and Functional Exercise Programs in the REX Powered Walking Aid

aut.relation.journalJournal of NeuroEngineering and Rehabilitationen_NZ
aut.researcherSignal, Nada
dc.contributor.authorBirch, Nen_NZ
dc.contributor.authorGraham, Jen_NZ
dc.contributor.authorPriestley, Ten_NZ
dc.contributor.authorHeywood, Cen_NZ
dc.contributor.authorSakel, Men_NZ
dc.contributor.authorGall, Aen_NZ
dc.contributor.authorNunn, Aen_NZ
dc.contributor.authorSignal, Nen_NZ
dc.description.abstractBackground The RAPPER II study investigates the feasibility, safety and acceptability of using the REX self-stabilising robotic exoskeleton in people with spinal cord injury (SCI) who are obligatory wheelchair users. Feasibility is assessed by the completion of transfer into the REX device, competency in achieving autonomous control and completion of upper body exercise in an upright position in the REX device. Safety is measured by the occurrence of serious adverse events. Device acceptability is assessed with a user questionnaire. Methods RAPPER II is a prospective, multi-centre, open label, non-randomised, non-comparative cohort study in people with SCI recruited from neurological rehabilitation centres in the United Kingdom, Australia and New Zealand. This is the planned interim report of the first 20 participants. Each completed a transfer into the REX, were trained to achieve machine control and completed Timed Up and Go (TUG) tests as well as upper body exercises in standing in a single first time session. The time to achieve each task as well as the amount of assistance required was recorded. After finishing the trial tasks a User Experience questionnaire, exploring device acceptability, was completed. Results All participants could transfer into the REX. The mean transfer time was 439 s. Nineteen completed the exercise regime. Eighteen could achieve autonomous control of the REX, 17 of whom needed either no assistance or the help of just one therapist. Eighteen participants completed at least one TUG test in a mean time of 313 s, 15 with the assistance of just one therapist. The questionnaire demonstrated high levels of acceptability amongst users. There were no Serious Adverse Events. Conclusions This first interim analysis of RAPPER II shows that it is feasible and safe for people with SCI to use the REX powered assisted walking device to ambulate and exercise in. Participants with tetraplegia and paraplegia could walk and perform a functional exercise program when standing needing only modest levels of assistance in most cases. User acceptability was high.
dc.identifier.citationJournal of neuroengineering and rehabilitation, 14(1), 60.
dc.publisherBioMed Centralen_NZ
dc.rights© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
dc.subjectSpinal cord injury; Tetraplegia; Paraplegia; Powered walking aid; Assistive technology; Physiotherapy; Rehabilitation; Robotics
dc.titleResults of the First Interim Analysis of the RAPPER II Trial in Patients With Spinal Cord Injury: Ambulation and Functional Exercise Programs in the REX Powered Walking Aiden_NZ
dc.typeJournal Article
pubs.organisational-data/AUT/Health & Environmental Science
pubs.organisational-data/AUT/Health & Environmental Science/Clinical Sciences
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences/HH Clinical Sciences 2018 PBRF
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