Congress – Musculoskeletal health in children and young people

HAYLEY COULSON

Hayley Coulson is a Physiotherapist with the Queensland Haemophilia Centre at the Queensland Children’s Hospital, Brisbane.

From a paediatric physiotherapy perspective, one of the standout sessions at the WFH 2026 World Congress focused on the future of comprehensive care for children and young people with bleeding disorders. Presentations from experts across several countries explored treatment advances, physical activity participation, musculoskeletal assessment and long-term wellbeing.

MSK Health in pediatrics beyond factor – from prophylaxis to function

Co-chairs ~ Adolfo Llinas, Colombia; Carlo Martinoli, Italy
Hematologist perspective – prophylaxis in era of novel therapies ~ Steven W. Pipe, USA
Degenerative joint changes in children with haemophilia: Early detection with ultrasound ~ Patricia Nally, Argentina
Integration of ultrasound and clinical-functional assessment (OSPAT and GAIT systems) ~ Elena A. Boccalandro, Italy
Is surgery an option in pediatric patients? ~ Walid Saied, Tunisia
Current challenges, barriers and enablers of physical activity in CHW ~ David Stephensen, UK
Strength training in hemophilia for adolescents ~ Joaquin Calatayud, Spain

Treatment approaches

One particularly impactful presentation was delivered by Dr Steven Pipe from the United States. Dr Pipe discussed the progress being made in treatment options for children and young adults with haemophilia. A key message from his presentation was the importance of flexibility in treatment planning, recognising that there is no longer a ‘one size fits all’ approach to treatment across a person’s lifespan, particularly in childhood. Instead, evolving therapies are increasingly allowing treatment to be tailored to an individual’s clinical needs, lifestyle and personal goals. Dr Pipe also presented encouraging outcome data from current product studies, including reports that almost 82% of patients experienced zero joint bleeds, while 64% achieved a zero annualised bleeding rate. Beyond bleed prevention, the presentation reinforced the growing focus on overall quality of life, including physical health, psychosocial wellbeing and participation in everyday activities.

Ultrasound and functional clinical assessment

Another thought-provoking session was delivered by Elena Boccalandro a physiotherapist from Italy, who discussed the FUSION study and its integrated approach to musculoskeletal assessment. Her research explored combining ultrasound assessment with functional clinical evaluation, encouraging a shift away from relying solely on isolated structural measures or traditional scoring systems such as the Haemophilia Joint Health Score. Instead, the study promoted a more comprehensive and functional model of assessment. This presentation prompted valuable reflection on current assessment practices within our own service and highlighted opportunities to further strengthen approaches to paediatric care as children transition into adolescence and adulthood.

Physical activity

Physical activity and participation in children with bleeding disorders was another primary focus of this session. David Stephenson from the United Kingdom presented on current challenges, barriers and enablers to physical activity participation in children. His presentation highlighted the positive impact that modern prophylaxis therapies are having on activity levels and sports participation, with research demonstrating increases in both general physical activity and engagement in sport. Importantly, David introduced the concept of ‘physical literacy’ — shifting the focus away from simply achieving a set number of minutes of exercise each day, and instead encouraging children to develop the motivation, confidence, knowledge and physical competence needed to remain active throughout life. This broader perspective strongly resonated with the multidisciplinary approach increasingly being adopted in paediatric centres across Australia.

Strength training

Building on this theme, Joaquin Calatayud from Spain presented evidence surrounding strength training in adolescents and tied this in with his recommendations for youth with bleeding disorders. His session addressed common myths and misconceptions regarding resistance training and emphasised the importance of appropriate supervision, gradual progression and correct technique. A key takeaway from this presentation was that strength training, when appropriately prescribed alongside prophylaxis management, is both safe and beneficial for young people with haemophilia and other bleeding disorders. Moderate-intensity exercise was highlighted as the most feasible and effective approach, while acknowledging the importance of adapting programs to account for pain, injury history and individual barriers to participation.

Attending the Congress reinforced the value of collaborative, evidence-based and patient-centred care and highlighted the exciting progress that continues to occur within paediatric haemophilia management worldwide. I am grateful to Haemophilia Foundation Australia for the opportunity to attend this year.

Hayley Coulson received funding from Haemophilia Foundation Australia for her WFH 2026 World Congress registration.