Performance-based activities of daily living using the Londrina ADL protocol in non-small cell lung cancer: A prospective cross-sectional controlled study: Performance-based ADL in NSCLC

Objective assessment of activities of daily living (ADL) in non-small cell lung cancer (NSCLC) remains limited despite its clinical importance. The Londrina ADL protocol enables standardized evaluation of real-life functional performance. This study aimed to evaluate performance-based ADL in NSCLC and identify determinants of impaired ADL performance. In this prospective cross-sectional controlled study, 23 NSCLC patients who had completed adjuvant treatment and 27 healthy controls underwent pulmonary function testing, muscle strength assessment, a 6-minute walk test (6MWD), quality-of-life evaluation, and Londrina ADL testing. Group comparisons, correlations, and multivariable linear regression were performed. Performance-based ADL is markedly impaired in NSCLC, and reduced exercise capacity is the principal determinant of real-life functional limitation. Objective ADL assessment may support early, capacity-targeted rehabilitation to preserve independence. NSCLC patients showed significantly longer Londrina ADL completion times than controls (335.6 ± 63.7 s vs 270.7 ± 34.4 s; P < .001) with reduced pulmonary function, muscle strength, and exercise capacity. Within NSCLC, ADL time correlated inversely with 6MWD ( r = −0.579, P = .004). Functional exercise capacity was the only independent predictor of ADL performance (β = −0.498, P = .022), and the model explained 36.1% of the variance in Londrina ADL completion time ( R 2 = 0.361).