Schwartz, A.L., Thompson, J.A., & Masood, N. (2002). Interferon-induced fatigue in patients with melanoma: A pilot study of exercise and methylphenidate. Oncology Nursing Forum, 29(7), E85–E90.

This study was conducted to examine the effect of exercise and methylphenidate (MPH) on fatigue, functional ability, and cognitive function in patients with melanoma. It also aimed to determine the percentage of patients who adhered to interferon-alfa, MPH, and exercise treatment.

The intervention group was given 20 mg of long-acting MPH every morning for four months and took part in at least 15–20 minutes of aerobic exercise four days per week. The duration and intensity of exercise gradually increased over the study's four months.

Assessments were completed prior to the first dose of interferon-alfa. Subsequent assessments of functional ability and cognition function (using Trail Making Test forms) and quality of life were repeated at one and four months after baseline. Subsequent assessments of fatigue scale, body weight, daily activity, and medication logs were submitted monthly.

• The total number of individuals involved in the study was 28.
• There were 12 participants and 16 historic controls. 
• The average age of the treatment group was 44, with a range of 20–64. Age information for the historic group was not provided.
• Gender information was not provided.
• 92% of the participants were Caucasian.
• The treatment group tended to have completed more years of formal education.
• Participants had newly diagnosed melanoma with surgical intervention, no prior treatment, and were actively undergoing treatment with interferon-alfa.

The study took place at a university-based cancer center.

This was a longitudinal pilot study with descriptive/exploratory design. It made use of a historic control group for comparison.

• The Trail Making Test (TMT) Parts A and B measured visual attention, motor speed, and cognitive flexibility.
• The Schwartz Cancer Fatigue Scale measured fatigue with 6 items. Scores range from 6–36, with higher scores indicating greater fatigue.
• The Medical Outcomes Study Short Form (SF-36) measured quality-of-life and global function with physical and mental health subscales. Scores range from 0–100, with higher scores indicating higher functioning.
• Adherence was measured with daily activity and medication logs.
• Body weight was measured to the nearest 0.1 kg and obtained monthly.

Functional ability increased an average of 6% for all participants and 9% for the treatment group. A percent change in a 12-minute walk was negatively related to TMT-A (p = 0.04) and TMT-B (p = 0.05), suggesting a relationship between higher exercise and improved cognitive functioning (indicated by lower scores on TMT). Taking MPH was correlated with improved TMT-B performance at 4 months (r = -0.85, p < 0.001). 

All participants' cognitive function scores were within normal ranges at baseline. Sixty-six percent of participants adhered to MPH at four months; all subjects continued to exercise at four months.

The combination of exercise and MPH has positive effects on cognitive function, functional ability, and fatigue over time. The authors suggest that MPH may have contributed to better exercise adherence.

• The study had a small sample size.
• One-third of the participants stopped taking MPH within the first week; for one participant, this was due to significant side effects related to anxiety.
• Two participants regularly exercised prior to enrollment, but the study did not address which group they were assigned to, potentially influencing outcomes.