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The use of physical interventions in the management of aggressive and violent behaviour continues to divide opinion and practice. In learning disability services, it is acknowledged that any physical intervention must be non‐aversive and considered as part of an overall programme which emphasises positive alternative behaviours. The author considers this understanding in the light of recent research and experience.

In June 2002 the Government issued long‐awaited guidance on the use of restrictive physical interventions. The need for the guidance was recognised in the White Paper, Valuing People, and its publication is anticipated in both the recently published National Care Standards and the 1996 Education Act. It represents a clear and unambiguous commitment by government departments to work together to improve practice across a range of services for adults and children with learning disabilities and autistic spectrum disorders, and for pupils with a range of special educational needs. The guidance is particularly addressed to staff working with adults and children with learning disabilities (including those with autistic spectrum disorders) and to those in special school settings responsible for pupils with severe behavioural difficulties associated with learning difficulties and/or autistic spectrum disorders. It will also be relevant to staff in schools which make provision for pupils with severe emotional and behavioural difficulties. This article describes the development of the guidance, the areas of practice it covers and its implications for managers, professionals, staff working directly with service users and family carers. It will do this by attempting to answer six questions. Why do we need new guidance on the use of restrictive physical interventions? Who will be affected by the guidance? How was the guidance developed? What does the guidance say? What needs to be done to implement the guidance? What still needs to be done?

One limitation of research that assesses the effectiveness of physical activity interventions for people with dementia is that most do not describe the intervention in sufficient detail to ascertain a theoretical basis or mechanism of action that determines the effective components. This paper aims to identify studies which evaluate the mechanisms of action of physical activity interventions for people with dementia, to further inform effective intervention development.

Papers were screened for evidence of evaluation of specific forms of physical activity, using pre-defined inclusion criteria. Analysis was conducted to ascertain if mechanisms of action were corroborated by data within and between studies.

The authors identified 26 studies with a measured mechanism of action; these related to the effects of physical activity on either neurological structure or endocrinal markers, including hormones. Physical activity had potential to reduce hippocampal atrophy, increase neural recruitment, activate the noradrenergic system and improve anti-inflammatory responses. While individual studies were hampered by small sample sizes, the body of evidence indicated that physical activity may have potential to delay cognitive decline.

Mechanisms of action in relation to dementia and physical activity are likely to be multifaceted, and physical activity may be protective against progression in the early stages of cognitive decline. Physical activity may be of greatest benefit if incorporated into on-going lifestyle, rather than engaged in for short periods, and combined with social interaction.

This paper is unique in its focus on the mechanisms of action of physical activity interventions for people with dementia.

The purpose of this paper is to test the effects of augmenting an evidence-based physical activity intervention within an existing commercial weight loss program to assess effects on increasing physical activity and reducing psychological distress.

The CONSORT guidelines were adopted for the study. In total, 49 women with overweight or obesity (M age=39.5, SD:12.4; M Body Mass Index=31.02, SD: 2.10) enrolled in a six week commercial weight loss program were randomized to an intervention or a control group. Participants in the control group received care as usual; participants in the intervention group additionally received an evidence-based intervention to increase physical activity that included behavior change techniques including implementation intentions, goal-setting and self-monitoring.

Weekly steps increased in the intervention group (M=31,516.25; SD=9,310.17 to M=62,851.36; SD=13,840.4) significantly more (p<0.001, η p 2 =0.32) than in the control group (M=30,207.67; SD=7,833.29) to M=46,969.33 (SD=9,470.96), along with experiencing significantly lower anxiety (p<0.001, η p 2 =0.15), social dysfunction (p<0.001, η p 2 =0.16) and depression symptoms (p<0.05, η p 2 =0.08) at follow-up.

This intervention warrants extension to those seeking to improve mental health through physical activity.

This study took a novel approach of augmenting a commercial weight loss program with a theory-based physical activity module, showing positive effects for physical activity behavior and psychological health.

This paper considers good practice in the use of physical interventions. It describes work undertaken to establish a consensus around policy principles in relation the use of personal restraints in response to violent behaviour by adults and children with a learning disability or autism. It highlights the benefits of clear local and national policies and identifies work required to promote good practice.

This paper aims to report a synopsis of a recent systematic review of the literature regarding the effectiveness of workplace physical activity interventions, commissioned by the National Institute for Health and Clinical Excellence (NICE).

A search for English‐language papers published between 1996 and 2007 was conducted using 12 relevant databases and associated grey literature. Search protocols and analysis regarding study quality as recommended by NICE were utilised. Key inclusion criteria were, workplace intervention aiming to increase physical activity, intervention aimed at working adults, intervention initiated/endorsed by the employer, physical activity outcome. Thirty‐three studies (38 papers) met the inclusion criteria and were independently reviewed (checked by two reviewers) with a narrative synthesis of findings.

Fourteen studies were graded as high quality or good quality. Evidence from previous systematic reviews was inconclusive. Data regarding the effectiveness of stair walking interventions was limited and intervention effects were short‐lived. Three public sector studies provided evidence that workplace walking interventions using pedometers can increase daily step counts. One good quality study reported a positive intervention effect on walking to work behaviour (active travel) in economically advantaged female employees. There was strong evidence that workplace counselling influenced physical activity behaviour. There is a dearth of evidence for small and medium enterprises.

Due to the necessary UK focus and time constraints, only studies from Europe, Australia, New Zealand and Canada were included.

The paper shows that there is a growing evidence base that workplace physical activity interventions can positively influence physical activity behaviour.

People with learning disabilities who present challenging behaviour are particularly vulnerable to physical abuse. It is argued that training in physical intervention could well be a critical variable in determining whether this abuse takes place. Recommendations designed to minimise the risks associated with physical intervention training are made.

A significant proportion of the world’s adult population is insufficiently active. One approach used to overcome barriers and facilitate participation in physical activity is social marketing. The purpose of this paper are twofold: first, this review seeks to provide a contemporary review of social marketing’s effectiveness in changing physical activity for the better; and second, it seeks to ascertain the extent that Andreasen’s (2002) six social marketing benchmark criteria have been applied in social marketing interventions targeting physical activity.

In total, 94 articles covering 26 social marketing interventions were identified following systematic literature review procedures.

None of the interventions gave evidence that they addressed all six social marketing benchmark criteria, and only four interventions addressed five criteria. The results indicate that three of the benchmark criteria, namely, behavioural objectives, formative research, and marketing mix are well utilised in social marketing interventions. Inclusion of market segmentation, exchange and competition offers potential to extend further on social marketing’s effectiveness in increasing physical activity.

The results of the current study indicate that increasing the number of benchmark criteria used in an intervention to at least four increases the chances of achieving positive behavioural outcomes.

Early interventions focusing on exercise and lifestyle are important for individuals with a diagnosis of psychosis due to increased risk of poor physical health and reduced life expectancy. This study aims to test the feasibility of a multicomponent lifestyle intervention for individuals with first episode psychosis (FEP).

Individuals attending an Irish FEP service were invited to engage in an eight-week programme including individual and group exercise sessions, group educational sessions and one dietician consultation. Physical activity, physical health, mental health, cognition and personal goals measures were completed pre- and post-intervention and analysed using descriptive statistics. Feasibility data was collected via a non-standardised participant questionnaire and informal data on completion of measures and engagement with the programme.

Ten participants with a diagnosis of FEP completed the intervention. Participants were satisfied with the intervention and adherence rates were high for weekly individual gym sessions but lower for group exercise and education sessions. Mean time spent engaging in physical activity increased and sedentary behaviours decreased. Participants indicated increased readiness for change with 90% moving to the action or maintenance stages of change. Participants attained 74% of their personal goals. There were no changes in average body mass index, cognition or mental health. Data relating to blood pressure, blood tests and steps was missing or incomplete.

This study indicates an eight-week exercise and lifestyle programme is feasible and acceptable in a clinical setting. Recommendations relating to satisfaction, clinical markers and resource requirements are made for future studies.

This review seeks to provide an overview of the current research evidence on the use of restraint as an intervention in managing challenging behaviours in relation to children with intellectual disabilities. It also aims to discuss legal frameworks and ethical considerations that underpin the use of restraint in intellectually disabled children who present with challenging behaviours.

The authors conducted a search of existing literature primarily pertaining to the management of challenging behaviours in intellectual disability on PubMed, PsycInfo and Google Scholar using combinations of the following key words – children, intellectual disabilities, learning disability, mental retardation, challenging behaviour, restraint, seclusion, physical restraint, mechanical restraint, personal restraint, and chemical restraint. Since research on the use of such interventions in children has been hitherto scant, literature relating to their use in intellectually disabled adult populations as well as cognitively able children was also examined to ascertain whether the broad principles informing the use of restraint interventions could be generalised to their use in intellectually disabled children.

The review finds evidence to suggest that restraint interventions in their myriad forms are widely used to manage challenging behaviours in children with intellectual disabilities and outlines the evidence base, clinical scope, and the risks associated with the use of such interventions in children. It also helps highlight the current absence of comprehensive evidence based guidance that incorporates clinical, ethical, and legal aspects of the use of restraint interventions in children with intellectual disabilities and raises relevant questions in relation to their judicious use in this patient group.

The authors believe that the review completes the first in depth evaluation of the use of restraint interventions in children with intellectual disabilities and are confident that this would serve as useful guidance for professionals working with this patient group who may be considering using restraint interventions in their everyday clinical practice.