Despite airway clearance being the mainstay of treatment for people with PCD, there are no available physiotherapy recommendations for adults with PCD. Following the commissioning of the adult PCD national management service in England, the adult PCD specialist physiotherapists developed the first adult physiotherapy standards of care (SoC).

The scope of the document is to ensure high quality, evidence-based, equitable physiotherapy care for all people with PCD in England and to provide a benchmark to audit services.

A literature search was carried out with all abstracts and full text screened by at least 2 authors. Inclusion criteria were: text available in English, population age limited to adults ? 16 years and studies published 2016 onwards if including cystic fibrosis (CF) and non-CF bronchiectasis. No age limit or timeframe were applied to studies in PCD.

Out of 2,229 initial studies, 72 (3.2%) were included in the literature review and used to develop the adult PCD physiotherapy SoC. The SoC have been created around six categories: airway clearance, inhaled medications, exercise for airway clearance, exercise, sinonasal management and transition.

The adult PCD physiotherapy SoC provide evidence-based recommendations and good practice points as a baseline of care for each of the six categories. However, there is low quality evidence and a lack of studies specific to PCD. This is due to small sample sizes and outcome measures not validated in PCD. Many treatment recommendations continue to be extrapolated from CF and non-CF bronchiectasis. 

Further research within PCD, using PCD specific outcome measures, is needed to provide evidence for the most effective physiotherapy treatment techniques in PCD.