An AI-Driven Multimodal Smart Home Platform for Continuous Monitoring and Assistance in Post-Stroke Motor Impairment

At-home rehabilitation for post-stroke patients presents significant challenges, as continuous, personalized care is often limited outside clinical settings. Moreover, the lack of integrated solutions capable of simultaneously monitoring motor recovery and providing intelligent assistance in home environments hampers rehabilitation outcomes. Here, we present a multimodal smart home platform designed for continuous, at-home rehabilitation of post-stroke patients, integrating wearable sensing, ambient monitoring, and adaptive automation. A plantar pressure insole equipped with a machine learning pipeline classifies users into motor recovery stages with up to 94% accuracy, enabling quantitative tracking of walking patterns during daily activities. An optional head-mounted eye-tracking module, together with ambient sensors such as cameras and microphones, supports seamless hands-free control of household devices with an average latency under 1 s with consistent operation. These data streams are fused locally via a hierarchical Internet of Things (IoT) architecture, ensuring low latency and data privacy. An embedded large language model (LLM) agent, Auto-Care, continuously interprets multimodal data to provide real-time interventions-issuing personalized reminders, adjusting environmental conditions, and notifying caregivers. Implemented in a post-stroke context, this integrated smart home platform increased mean user satisfaction from 3.9~± ~0.8 in conventional home environments to 8.4~± ~0.6 with the full system (n = 20). Beyond stroke, the system offers a scalable, patient-centered framework with potential for long-term use in broader neurorehabilitation and aging-in-place applications.