Objective To investigate the effect of lower limb rehabilitation training robot combined with task-oriented training on walking ability after stroke. Methods From February 2014 to August 2015,74 consecutive patients with post-stroke who received rehabilitation therapy and met the inclusion criteria admitted to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were collected prospectively. They were all the patients with the first-ever stroke for 1 to 12 months. They were divided into either an observation group (n = 39)or a control group (n = 35)according to whether they were treated with the lower-limb rehabilitation robot. The patients of both groups received task-oriented training,2 times a day,once for 20 min,5 days a week for 12 weeks. The observation group was also treated with the lower-limb rehabilitation training robot,1 time a day,once for 30 min,5 days a week. Berg balance scale,Fugl-Meyer assessment (FMA),timed up-and-go test (TUG)and knee flexion active range of motion (KFAROM)were used to assess the efficacy. Results (1)After treatment,the Berg scale and FMA scale scores were increased in the observation group and the control group compared with before treatment. There was significant difference (Berg scale:28 ±9 vs. 22 ±9,29 ±9 vs. 24 ±9;FMA scores:47 ± 8 vs. 36 ± 8,40 ± 6 vs. 36 ± 7;all P < 0. 01),however,there was no significant difference between the two groups (P <0. 05),and there was significant difference in FMA scores between the 2 groups (P < 0. 01 ). The differences of Berg scale scores in the observation group and the control group were 10. 75 + 0. 30 and 4. 71 + 0. 14 respectively before and after treatment. There was no significant difference between the 2 groups (t = 0. 95,P = 0. 345). The differences of FMA scores in the observation group and the control group were 5. 8 ±0. 6 and 4. 9 ±0. 8 before and after treatment (t =5. 16,P <0. 01). (2)After treatment,the tug test and KFAROM of the observation group and the control group were better than those before treatment. There were significant differences (TUG test:35 ± 13 s vs. 56 ± 18 s,53 ± 17 s vs. 58 ± 18 s;KFAROM:82 ± 24° vs. 60 ± 23°,63 ± 23° vs. 57 ± 26°;all P < 0. 01),and there were significant differences between the 2 groups (all P < 0. 01). The differences of the TUG test in the observation group and the control group before and after treatment were 21. 5 ± 5. 0 and 4. 6 ± 0. 6 s respectively. There was significant difference between the 2 groups (t = 9. 55,P < 0. 01);the differences of KFAROM in the observation group and control group before and after treatment were 5.8 ±0.6° vs. 4.9 ±0.8° respectively. There was significant differences between the 2groups (t =4.17,P <0. .01). Conclusion Lower limb rehabilitation training robot combined with task-oriented training may improve the lower extremity motor function,walking ability,knee flexion joint activity of the patients after stroke,but the improvement effect of the lower limb balance is not obvious.%目的：探讨下肢康复机器人联合任务导向训练对卒中后步行能力的康复作用。方法前瞻性连续收集2014年2月至2015年8月首都医科大学宣武医院康复科住院及门诊进行康复治疗且符合纳入标准的卒中患者74例，均为发病1～12个月的初发卒中，根据患者是否接受下肢康复机器人治疗分为观察组（39例）和对照组（35例）。两组患者均接受任务导向训练，2次／ d，20 min ／次，5 d ／周，共12周。观察组另给予12周的下肢康复机器人治疗，1次／ d，30 min ／次，5 d ／周。疗效评定采用Berg平衡量表、Fugl-Meyer运动功能量表（FMA）、站起-行走计时（TUG）测试、膝关节屈曲的主动关节活动度评测（KFAROM）。结果（1）治疗后，观察组与对照组Berg量表和FMA量表评分均较治疗提高，差异均有统计学意义[Berg量表：（28±9）分比（22±9）分，（29±9）分比（24±9）分；FMA评分：（47±8）分比（36±8）分，（40±6）分比（36±7）分；均P ＜0.01]，但组间Berg评分比较差异无统计学意义（P ＞0.05），而组间FMA量表评分的差异有统计学意义（P ＜0.01）。观察组与对照组治疗前后Berg 量表评分的差值分别为（10.75±0.30）、（4.71±0.14）分，组间差异无统计学意义（t ＝0．95，P ＝0．345）；观察组与对照组治疗前后FMA量表评分的差值分别为（5.8±0.6）、（4.9±0.8）分，组间差异有统计学意义（t ＝5.16，P ＜0．01）。（2）治疗后，观察组与对照组TUG测试及KFAROM 均较治疗前改善，差异均有统计学意义[TUG测试：（35±13）s 比（56±18）s，（53±17）s 比（58±18）s；KFAROM：（82±24）°比（60±23）°，（63±23）°比（57±26）°；均P ＜0.01]，且组间差异均有统计学意义（均P ＜0.01）。观察组与对照组治疗前后TUG测试的差值分别为（21.5±5.0）、（4.6 ±0.6）s，组间差异有统计学意义（t ＝9.55，P ＜0．01）；观察组与对照组治疗前后KFAROM的差值分别为（5.8±0.6）、（4.9±0.8）°，组间差异有统计学意义（t ＝4.17，P ＜0．01）。结论任务导向性联合下肢康复机器人训练可改善卒中后患者下肢运动功能、行走能力、膝关节屈曲的关节活动度，但对下肢平衡改善效果不明显。
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