Intelligent assistive devices that integrate artificial intelligence, robotics and other technologies provide new opportunities to improve the efficiency and professionalism of home-based rehabilitation. This paper outlines the classification and technical principles of intelligent assistive devices, analyzes their application bottlenecks in home scenarios from three dimensions of technical reliability, user compliance and social support, and on this basis, proposes a comprehensive optimization path of improving environmental adaptability through technical iteration, building a precise adaptation service system relying on rehabilitation nurses, and improving the security network with the help of policy coordination, aiming to promote the intelligent and sustainable development of stroke home-based rehabilitation.