Rehabilitation interventions in bronchiectasis: expanding evidence, personalization, and clinical practice

Area of Science:

• Respiratory Medicine
• Rehabilitation Science

Background:

• Bronchiectasis is a chronic respiratory disease with irreversible airway dilation, recurrent infections, and inflammation.
• Pulmonary rehabilitation is recommended but inconsistently implemented, with limited access to programs.

Purpose of the Study:

• To synthesize contemporary evidence on rehabilitation interventions for bronchiectasis.
• To discuss current controversies, research gaps, and future directions in bronchiectasis rehabilitation.

Main Methods:

• Review of contemporary evidence on rehabilitation interventions for bronchiectasis.
• Integration of established practices with emerging strategies.
• Critical discussion of controversies, research gaps, and future directions.

Main Results:

• Airway clearance and exercise training are foundational but require individualized prescription based on patient profiles.
• Multimodal approaches incorporating physical activity, adjunct interventions, and tele-rehabilitation show promise.
• Patient-centered, phenotype-informed strategies are needed due to persistent uncertainties.

Conclusions:

• Broadening rehabilitation beyond traditional paradigms can enhance clinical relevance and functional outcomes in bronchiectasis.
• Individualized, multimodal rehabilitation strategies are crucial for managing this complex disease.
• Further research is needed to optimize prescription, implementation, and long-term outcomes.