People with profound intellectual disabilities rarely experience a physically active lifestyle, and their long‐term physical inactivity likely contributes to poor health. The authors developed and implemented a pilot exercise program for persons with a profound intellectual disability and conducted a study to evaluate the effort. The development of mobility, independent movement, and posture profiles resulted in a 16‐week needs‐led exercise program based on “rebound therapy,” with additional exercises, including active and passive exercise, walking, swimming, hydrotherapy, and team games. Study participants undertook 3–5 additional periods of low‐impact exercise per week, providing moderate to low levels of activity judged in terms of energy costs. The program was evaluated using physiological measures (resting pulse, systolic and diastolic blood pressure, weight, height, body mass index, seizure activity, activity levels), counts of challenging behaviors, and by indices of quality of life and alertness outcomes. Participation in the exercise program was associated with decreases of frequency of challenging behaviors and increases in quality of life (freedom scores) and alertness. The authors concluded that barriers to the development and implementation of ongoing exercise programs in continuing care settings can be overcome by trained and motivated care staff.

The aim of this study was to evaluate whether involvement in a 16 week exercise programme improved goal attainment in areas of behaviour, access to community-based experiences, health and physical competence. Participants were women with severe intellectual disability and associated challenging behaviour (setting A,N = 14) and male/female service users with profound physical and intellectual disabilities (setting B,N = 8). The exercise programme included active and passive exercise, walking, swimming, hydrotherapy, team games and rebound therapy. Significant gains in aggregated goal attainment were demonstrated by week 16. The reliability and validity of our goal attainment procedures were demonstrated with inter-rater reliabilities exceeding 80 percent. Changes in goal attainment were concurrent with global clinical impression scores in a series of single case studies. Continuing care settings should dedicate care staff to provide routinized, continuing exercise programmes.

Accessible summary• Some people with a learning disability have behaviours that are hard for services to cope with. • This study looked at a team that tried to help these people to stay in their own homes instead of having to move to a different area. • The study looked at the good things about the team and things that could be better. • We found that the team helped the services to support people in a different way, so that there were fewer behaviours which were hard to manage. SummaryThis article evaluates an assertive outreach team which aimed to help support people with a learning disability who displayed challenging behaviour in their own environment. The service was evaluated using Maxwell's Multi-dimensional Quality Evaluation Model (Maxwell 1984), which recognises that different stakeholders in a service are likely to focus on different indices of quality including effectiveness, efficiency, economy, equity, access to services, appropriateness and social acceptability. The main strengths of the team were staff skills and professionalism, whereas the most frequently cited weaknesses centred around issues of liaison, communication and the role and remit of the team.