{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:17:12Z","timestamp":1788171432390,"version":"build-2803163510"},"reference-count":81,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370001"],"award-info":[{"award-number":["82370001"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"award":["82370001"],"award-info":[{"award-number":["82370001"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Key Research and Development Project of the Sichuan Provincial Science and Technology Program","doi-asserted-by":"publisher","award":["2024YFFK0071"],"award-info":[{"award-number":["2024YFFK0071"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Technology Projects of the Xizang Autonomous Region, China","award":["XZ202502ZY0008"],"award-info":[{"award-number":["XZ202502ZY0008"]}]},{"name":"Special Research Project of the National Health Commission Capacity Building and Continuing Education Center","award":["GWJJZX20251002033"],"award-info":[{"award-number":["GWJJZX20251002033"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Primary ciliary dyskinesia (PCD) is an inherited motile-cilia disorder. Impaired mucociliary transport promotes persistent secretion retention, infection, inflammation, and bronchiectasis. The central treatment problem is therefore failure of airway clearance rather than infection alone. This narrative review evaluates airway clearance techniques (ACTs), mucoactive adjuncts, and pulmonary rehabilitation for children and adolescents. We prioritize direct pediatric PCD evidence, identify mixed-age or adult PCD findings as population-bound PCD evidence, and label pediatric bronchiectasis and cystic fibrosis evidence as indirect. Because no ACT has been shown to be universally superior and pediatric rehabilitation evidence remains limited, we present an author-proposed clearance-anchored dual-pillar framework. ACTs directly address mucus retention. Pulmonary rehabilitation complements ACT by targeting fitness, muscle performance, participation, and self-management. Response should be assessed across four domains: clinical stability, treatment performance, physiological and functional outcomes, and patient and family experience. Prospective multicenter comparative trials and harmonized pediatric outcome measures are urgently needed.<\/jats:p>","DOI":"10.3390\/jcm15176676","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:21:19Z","timestamp":1788168079000},"page":"6676","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Airway Clearance and Pediatric Pulmonary Rehabilitation in Primary Ciliary Dyskinesia: A Clinical Framework for Children and Adolescents"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1324-3988","authenticated-orcid":false,"given":"Jiahui","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Pediatric Pulmonology, West China Second University Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonology, West China Second University Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonology, West China Second University Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4633-911X","authenticated-orcid":false,"given":"Hanmin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonology, West China Second University Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China"},{"name":"NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu 610041, China"},{"name":"Department of Pediatric Pulmonology and Immunology, WCSUH-Tianfu\u00b7Sichuan Provincial Children\u2019s Hospital, Sichuan University, Meishan 620010, China"},{"name":"The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital, Sichuan University and School of Life Sciences of Fudan University, West China Institute of Women and Children\u2019s Health, West China Second University Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Sichuan Birth Defects Clinical Research Center, West China Second University Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Xizang Region Child Development Clinical Medical Research Center, Lhasa 850000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1542\/peds.2014-0808","article-title":"Primary ciliary dyskinesia and neonatal respiratory distress","volume":"134","author":"Mullowney","year":"2014","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e2023063064","DOI":"10.1542\/peds.2023-063064","article-title":"Primary ciliary dyskinesia","volume":"153","author":"Wee","year":"2024","journal-title":"Pediatrics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2500745","DOI":"10.1183\/13993003.00745-2025","article-title":"European respiratory society and american thoracic society guidelines for the diagnosis of primary ciliary dyskinesia","volume":"66","author":"Shoemark","year":"2025","journal-title":"Eur. 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