Physiotherapy With Positive Expiratory Pressure (PEP) Bottle in Patients With Bronchiectasis

Inclusion Criteria: * Subject over 18 years of age * Confirmed diagnosis of bronchiectasis based on high-resolution chest CT, showing bronchial dilation according to one or more of the following radiological criteria in accordance with the 2019 BTS guidelines. * Ratio between the internal lumen of the bronchus and the adjacent pulmonary artery \>1 * Absence of normal bronchial tapering * Visibility of the airways within 1 cm from the pleura * Subject with chronic bronchial hypersecretion (daily secretion ≥ 15ml) * Patients capable of performing physiotherapy using the PEP bottle * Patients capable of performing global spirometry Exclusion Criteria: * Subject already undergoing regular respiratory physiotherapy * Subject without significant bronchial hypersecretion * Concomitant diagnosis of Cystic Fibrosis, Primary Ciliary Dyskinesia, NTM-PD, TB, Sarcoidosis, Active Neoplasia * Diagnosis of Asthma according to the 2023 GINA guidelines, defined as documented excessive variability in pulmonary function (positive bronchodilation or bronchoprovocation test with methacholine, or diurnal variability of PEF) + documented limitation of expiratory airflow. * Diagnosis of COPD according to the 2023 GOLD guidelines, defined as FEV/FVC post-bronchodilation \<0.7 on forced spirometry in the presence of suggestive symptoms (dyspnea, chronic cough, sputum production) and/or exposure to risk factors for the disease (e.g., cigarette smoking). * Contraindications to PEP-Bottle Physiotherapy (Pneumothorax; Hemoptysis; Myocardial infarction in the 4 weeks prior to informed consent signature) * Exacerbation of disease in the previous 4 weeks * Use of inhalation therapy in the 4 weeks prior to informed consent signature * Active smoker * Subject undergoing non-invasive ventilation or with a tracheostomy * Inability to provide informed consent