Abstract Background and aims In acute stroke rehabilitation timely and frequent motor practice is essential for recovery (1,2). Staffing pressures and high patient volumes can limit opportunities for 1:1 therapy, potentially reducing daily activity time (3,4). We introduced an "open gym" model to increase patient-led activity, promote social interaction, and maximise staff efficiency. How can introducing an open gym model increase patient-led activity, promote social interaction and maximise staff efficiency? Methods An open gym space was established, allowing patients to access functional exercise equipment and participate in activities outside of scheduled therapy sessions. One physiotherapist and one rehabilitation assistant facilitated safe use but encouraged self-directed exercise and peer interaction. Data was collected over 4 weeks each at two stamp points (December 2024 and August 2025), comparing the average number of minutes of activity overall, number of patients seen by therapists and qualitative feedback from patients. Results Findings show an increase in average motor activity time in an open gym setting compared to a 1:1 session per patient. The number of patients engaged in rehabilitation activities per therapist increased. Patient feedback highlighted enhanced motivation, an increase in the number of repetitions achieved and understanding of why exercise is important. Conclusions The open gym model in acute stroke rehab can increase motor activity time, enhance social engagement, and promote accountability, offering a viable solution for maximising recovery opportunities when resources are limited. Conflict of interest Hayley West: nothing to disclose
Hayley West (Fri,) studied this question.