These are barriers that are widely acknowledged and understood by day and residential staff and participants in the study, but are arguably poorly understood by policy makers, health promotion agencies, commissioners and providers of learning disability services. The current lack of resources and inadequately specified responsibilities associated with community care deny many people with learning disabilities real choices to live a physically active healthy lifestyle.

The aim of the study was to evaluate the cardiorespiratory fitness, levels of obesity, daily levels of physical activity and barriers to a physically active lifestyle in a group of 24 adults with mild and moderate learning disabilities (aged 2 3 4 7 years, mean age 34). The efficacy of two community-based exercise intervention programmes for the group was also evaluated. The results showed that overall 50% of the men and 70% of the women were overweight, of whom 57% of the men and 100% of the women were obese. Mean cardiorespiratory fitness levels were 20% to 28% lower for the men and 42% lower for the women compared with average values for the general population. Physical activity profiles indicated that 22 of the participants were below recognised minimum levels of physical activity. Barriers to physical activity specific to the learning disability population included transport needs, staffing ratios, financial resources and unclear policy guidelines for day and residential service provision.

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Few adults with learning disabilities can choose to walk to work, go for a run or visit the local swimming pool without adequate support. This study suggests that there may not be enough moderate or vigorous physical activity choices available in day and residential care settings to empower adults with mild and moderate learning disabilities to meet the minimum recommendations of the Department of Health. Hence some people with learning disabilities have no alternatives to a sedentary lifestyle and the health risks associated with physical inactivity.