Lack of physical activity is a major risk factor in non-communicable diseases, increasing the all-cause mortality risk by 20–30%. It is also an important risk factor for dementia. While it can be difficult in any individual to ascertain the relevant contribution of lifestyle factors, interventions that target physical activity behaviours are important primary and secondary prevention strategies. We need public health approaches to increase the whole population’s physical activity. However, we argue that these interventions should particularly focus on higher risk groups, notably those with physical disabilities.

People with disabilities are half as likely as non-disabled people to be physically active.¹ Those living with neurological conditions such as stroke, Parkinson’s disease and multiple sclerosis are generally even more sedentary, as are those with rarer neurological disorders such as neuromuscular diseases, motor neuron disease, Huntington’s disease, progressive supranuclear palsy, multiple system atrophy, inherited ataxias and hereditary spastic paraplegia. This …