Background <p>Post-stroke lower limb dysfunction affects the quality of life. Previous studies have confirmed that lower limb exoskeleton robots can improve the walking ability of stroke patients. This study aims to explore the impact of the UGO220 exoskeleton rehabilitation robot on the motor function and daily living ability of chronic stroke patients and to observe changes in lower limb muscle activity by surface electromyography before and after treatment.</p> Methods <p>Sixty stroke patients with hemiplegia were randomly divided into a conventional (CT, <i>n</i> = 30) group or a robot (RT, <i>n</i> = 30) group. Patients in both groups received 60&#xa0;min of routine physical therapy and occupational therapy. The robot group received 30&#xa0;min of lower limb exoskeleton robot-assisted gait training per day, whereas the conventional group received 30&#xa0;min of physical therapist-assisted gait training per day, six days a week, for three consecutive weeks. The primary outcome was evaluated by Fugl-Meyer assessment-lower extremities (FMA-LE), and the secondary outcomes included the modified Barthel index (MBI) score, Berg balance scale (BBS), and lower extremity muscle surface electromyography (sEMG) of the rectus femoris, biceps femoris, anterior tibialis and medial gastrocnemius muscles, including the integrated EMG (iEMG) and root-mean-square (RMS) values.</p> Results <p>The robot group had significantly greater improvements in FMA-LE and MBI compared to the conventional group. The electromyography results indicated that in terms of the activation of the anterior tibial muscle, the robot group performed better than the traditional group.</p> Conclusions <p>The UGO220 exoskeleton robot training is superior to conventional training in improving Activities of daily living and lower limb motor function. Moreover, it can better promote the improvement of the ankle dorsiflexion function.</p> Trial registration <p>ClinicalTrials.gov (ChiCTR2500096316)(2025-01-21).</p>