{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T09:28:48Z","timestamp":1774430928783,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:p>Bronchiectasis is a chronic and heterogeneous respiratory disease characterized by irreversible airway dilation, recurrent infection, persistent inflammation, and progressive functional impairment. Pulmonary rehabilitation is consistently recommended in international guidelines as a core non-pharmacological intervention; however, its implementation in clinical practice remains inconsistent and access to comprehensive rehabilitation programmes remains limited despite strong guideline endorsement. Recent advances in disease conceptualization, particularly the treatable traits framework, together with growing evidence supporting exercise training, physical activity promotion, and digitally enabled care models, have expanded the scope and relevance of rehabilitation in bronchiectasis. This Mini Review synthesizes contemporary evidence on rehabilitation interventions, integrating established practices with emerging strategies, and critically discusses current controversies, research gaps, and future directions. While airway clearance and exercise training remain foundational, current European Respiratory Society guidance supports their use based on defined patient profiles and evidence strength, and increasing evidence supports individualized, multimodal rehabilitation approaches that incorporate physical activity promotion, adjunct interventions, home-based and tele-rehabilitation models, and patient-managed strategies. Persistent uncertainties regarding optimal prescription, implementation, and long-term outcomes underscore the need for patient-centered, phenotype-informed rehabilitation strategies. Broadening rehabilitation beyond traditional paradigms may enhance clinical relevance, improve functional outcomes, and better align care with the complex and evolving nature of bronchiectasis.<\/jats:p>","DOI":"10.3389\/fresc.2026.1785522","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:55:29Z","timestamp":1774421729000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rehabilitation interventions in bronchiectasis: expanding evidence, personalization, and clinical practice"],"prefix":"10.3389","volume":"7","author":[{"given":"Antonio M.","family":"Esquinas","sequence":"first","affiliation":[{"name":"Hospital General Universitario Jose M Morales Meseguer","place":["Murcia, Spain"]},{"name":"NIV-ICU Group, Biomedical Research Institute Pascual Parrilla","place":["Murcia, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando Silva","family":"Guimaraes","sequence":"additional","affiliation":[{"name":"Rehabilitation Sciences Graduate Program and Faculty of Physical Therapy, Federal University of Rio de Janeiro","place":["Rio de Janeiro, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"108593","DOI":"10.1016\/j.rmed.2025.108593","article-title":"Bronchiectasis and treatable traits: the journey from concept to clinical practice","volume":"251","author":"Marrades","year":"2026","journal-title":"Respir Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1001\/jama.2025.2680","article-title":"Non\u2013cystic fibrosis bronchiectasis in adults: a review","volume":"334","author":"Barker","year":"2025","journal-title":"JAMA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2400518","DOI":"10.1183\/13993003.00518-2024","article-title":"Bronchiectasis management in adults: state of the art and future directions","volume":"63","author":"Choi","year":"2024","journal-title":"Eur Respir J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2501126","DOI":"10.1183\/13993003.01126-2025","article-title":"European Respiratory Society clinical practice guideline for the management of adult bronchiectasis","volume":"66","author":"Chalmers","year":"2025","journal-title":"Eur Respir J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"107503","DOI":"10.1016\/j.rmed.2023.107503","article-title":"Applying the treatable traits approach in bronchiectasis","volume":"222","author":"Watson","year":"2024","journal-title":"Respir Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"4302","DOI":"10.21037\/jtd-2024-2106","article-title":"Addressing treatable traits in bronchiectasis through non-pharmacological therapies: a narrative review","volume":"17","author":"Lee","year":"2025","journal-title":"J Thorac Dis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2202053","DOI":"10.1183\/13993003.02053-2022","article-title":"European Respiratory society statement on airway clearance techniques in adults with bronchiectasis","volume":"62","author":"Herrero-Cortina","year":"2023","journal-title":"Eur Respir J"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2301689","DOI":"10.1183\/13993003.01689-2023","article-title":"Airway clearance management in people with bronchiectasis: data from the European bronchiectasis registry (EMBARC)","volume":"63","author":"Spinou","year":"2024","journal-title":"Eur Respir J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"2301504","DOI":"10.1183\/13993003.01504-2023","article-title":"Diagnostic delay and access to care in bronchiectasis: data from the EMBARC\/ELF patient survey","volume":"64","author":"Spinou","year":"2024","journal-title":"Eur Respir J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2300741","DOI":"10.1183\/13993003.00741-2023","article-title":"Airway clearance techniques and exercise in people with bronchiectasis","volume":"62","author":"Herrero-Cortina","year":"2023","journal-title":"Eur Respir J"},{"key":"B11","doi-asserted-by":"publisher","first-page":"00648","DOI":"10.1183\/23120541.00648-2025","article-title":"Addressing sputum challenges in bronchiectasis: high-flow therapy as a game-changer for airway clearance care","volume":"11","author":"Herrero-Cortina","year":"2025","journal-title":"ERJ Open Res"},{"key":"B12","doi-asserted-by":"publisher","first-page":"CD013110","DOI":"10.1002\/14651858.CD013110.pub2","article-title":"Exercise training for bronchiectasis","volume":"4","author":"Lee","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1802474","DOI":"10.1183\/13993003.02474-2018","article-title":"Pulmonary rehabilitation for bronchiectasis: if not now, when?","volume":"53","author":"Metersky","year":"2019","journal-title":"Eur Respir J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1479638","DOI":"10.3389\/fmed.2025.1479638","article-title":"Impact of physical activity on all-cause mortality in individuals with non-cystic fibrosis bronchiectasis","volume":"12","author":"Kim","year":"2025","journal-title":"Front Med (Lausanne)"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1902138","DOI":"10.1183\/13993003.02138-2019","article-title":"Association between physical activity and risk of hospitalisation in bronchiectasis","volume":"55","author":"Alcaraz-Serrano","year":"2020","journal-title":"Eur Respir J"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.3390\/jcm10061190","article-title":"Exacerbations and changes in physical activity and sedentary behaviour in patients with bronchiectasis after 1 year","volume":"10","author":"Alcaraz-Serrano","year":"2021","journal-title":"J Clin Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1097\/HCR.0000000000000983","article-title":"Home-Based rehabilitation with health coaching in patients living with bronchiectasis","volume":"45","author":"Batzlaff","year":"2025","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1571837","DOI":"10.3389\/fmed.2025.1571837","article-title":"Role of home-based pulmonary rehabilitation programs for disease progression and quality of life in patients with stable bronchiectasis: a single-center RCT","volume":"12","author":"Min","year":"2025","journal-title":"Front Med (Lausanne"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e76801","DOI":"10.2196\/76801","article-title":"Clinical efficacy of smartphone app-based pulmonary rehabilitation in chronic respiratory diseases: randomized controlled and feasibility trials","volume":"27","author":"Chung","year":"2025","journal-title":"J Med Internet Res"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.4081\/monaldi.2025.3139","article-title":"Airway clearance techniques by video consultation for patients with bronchiectasis: satisfaction, adherence, effectiveness, and safety. A pilot study","author":"Bala\u00f1\u00e1 Corber\u00f3","year":"2025","journal-title":"Monaldi Arch Chest Dis"},{"key":"B21","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3390\/reports7030057","article-title":"The effects of hybrid tele airway clearance in bronchiectasis patients: a case series","volume":"7","author":"Nwe","year":"2024","journal-title":"Reports (MDPI)"},{"key":"B22","doi-asserted-by":"publisher","first-page":"00013","DOI":"10.1183\/23120541.00013-2024","article-title":"Digital technologies in bronchiectasis physiotherapy services: a survey of patients and physiotherapists in a UK centre","volume":"10","author":"O'Neill","year":"2024","journal-title":"ERJ Open Res"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e13","DOI":"10.1164\/rccm.201309-1634ST","article-title":"ATS\/ERS task force on pulmonary rehabilitation. An official American thoracic society\/European respiratory society statement: key concepts and advances in pulmonary rehabilitation","volume":"188","author":"Spruit","year":"2013","journal-title":"Am J Respir Crit Care Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"17534666251390086","DOI":"10.1177\/17534666251390086","article-title":"Screening and impact of comorbidities in bronchiectasis: a forward-looking perspective","volume":"19","author":"De Angelis","year":"2025","journal-title":"Ther Adv Respir Dis"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e34101","DOI":"10.1016\/j.heliyon.2024.e34101","article-title":"Development of a core outcome set for physiotherapy trials in bronchiectasis","volume":"10","author":"Hamzeh","year":"2024","journal-title":"Heliyon"}],"container-title":["Frontiers in Rehabilitation Sciences"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fresc.2026.1785522\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:55:30Z","timestamp":1774421730000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fresc.2026.1785522\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":25,"alternative-id":["10.3389\/fresc.2026.1785522"],"URL":"https:\/\/doi.org\/10.3389\/fresc.2026.1785522","relation":{},"ISSN":["2673-6861"],"issn-type":[{"value":"2673-6861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"article-number":"1785522"}}