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Non-communicable diseases (NCDs), including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers, are on the rise worldwide and are often associated with a lack of physical activity (PA). Globally, the levels of PA among individuals are below WHO recommendations. A lack of PA can increase morbidity and mortality, worsen the quality of life and increase the economic burden on individuals and society. In response to this trend, numerous organisations came together under one umbrella in Hamburg, Germany, in April 2021 and signed the 'Hamburg Declaration'. This represented an international commitment to take all necessary actions to increase PA and improve the health of individuals to entire communities. Individuals and organisations are working together as the 'Global Alliance for the Promotion of Physical Activity' to drive long-term individual and population-wide behaviour change by collaborating with all stakeholders in the community: active hospitals, physical activity specialists, community services and healthcare providers, all achieving sustainable health goals for their patients/clients. The 'Hamburg Declaration' calls on national and international policymakers to take concrete action to promote daily PA and exercise at a population level and in healthcare settings., Competing Interests: Competing interests: EV is Editor in Chief of BMJ Open Sports & Exercise Medicine., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To assess the outcome of conservative treatment for chronic exertional compartment syndrome (CECS) as it relates to the reduction in surgical fasciotomy and return to active duty in a military population., Methods: Historic cohort. From 2015 to 2018, 75 surgically eligible patients with pressure-positive anterior CECS (Group 1), or with positive pressures and associated medial tibial stress syndrome (Group 2), underwent a conservative treatment programme emphasising gait retraining of running and marching. Treatment success was defined as return to duty, without surgery. Fifty patients from 2015 to 2017 were surveyed to assess mid-term outcomes., Results: The average duration of conservative treatment was 144.9 (±59.6) days. Initially, 65% (49/75) were able to return to duty; 28% (21/75) were referred for surgery and 7% (5/75) left the armed forces. There was no difference in outcomes between Group 1 and Group 2. Survey response rate, on average after 742 days (SD 267, range 381-1256), was 84% (42/50); 57% (24/42) had continued duty, without surgery; of them, 43% were at the same military specialty, 57% in a physically less demanding job., Conclusion: A conservative treatment programme for anterior CECS was able to return 65 % of patients to active duty, without surgery. At 2 years, the success rate decreased slightly, but remained positive at 57%. In this high-risk group, initiating a conservative treatment protocol with an emphasis on gait retraining can significantly reduce the need for surgical fasciotomy. For those that fail conservative treatment, surgical release may still be indicated., Competing Interests: Competing interests: None declared.

Introduction: While numerous publications have demonstrated the correlation of poor single-leg balance and core motor control with an increased risk of anterior cruciate ligament (ACL) injuries in skeletally mature female athletes, few have analysed the preadolescent population regarding when indeed comparative deficits in balance and core control actually occur. The purpose of this study was to assess whether the neuromotor factors that place mature females at increased risk of ACL injury actually are present in preadolescents and if so when., Methods: This study used simplified modifications of classic drop-jump testing as well as single-leg balance tests performed on stable and unstable surfaces to assess balance and core motor control. 84 children (males and females) ranging in age from 6 to 13 years were divided into 4 equally sized groups based on their academic classes. Each group was compared with each other, and compared with a cohort of 205 collegiate athletes. The latter served as a comparative norm of mature athletes who had performed the same or similar testing., Results: Outcomes revealed that the preadolescent population performed poorly on the tests when compared with the collegiate population but the children matured with age until the eldest subgroups compared more favourably with the college-aged athletes. Girls appear to mature at a slightly earlier pace than boys. This study focusing on preadolescent children concluded that the neuromuscular changes that place females at greater risk of injury do not appear to occur prior to adolescence., Conclusions: Based on the outcomes of this study, it is suggested that sex differences regarding balance and core control deficits that can increase risk of ACL injuries likely occur after grade school (age 12-13).