Systematic review of physical activity interventions assessing physical and mental health outcomes on patients with severe mental illness (SMI) within secure forensic settings.

The review found only four studies, with 112 participants total. Three included studies had no control group, and methodological quality ranged from poor to moderate. No included study had long-term follow-up. Interventions varied in type, frequency, duration and dose, and outcome measures were inconsistent, so the best programme cannot be identified. Some interventions combined physical activity with education, diet advice, goal setting or token behaviour therapy, so the effect of physical activity alone cannot be isolated. Attrition and reasons for dropout were incompletely reported, and behavioural outcomes such as violence were not measured.

Do not read the improvements as proof that physical activity alone works in secure forensic settings. Some programmes also included education, diet advice, goal setting or token behaviour therapy, and the evidence came from four small studies, three had no control group, quality was poor to moderate, and none had long-term follow-up.