Effects of Combined Music and Caffeine on Psychophysiological Responses During Exercise: A Systematic Review and Exploratory Meta-Analysis

Background: This systematic review and exploratory meta-analysis evaluated the effects of combined music and caffeine on psychophysiological responses during exercise. Methods: PubMed, Embase, Web of Science, and the Cochrane Library were searched from database inception to 10 June 2026. Randomized crossover studies comparing caffeine plus music with placebo plus no music, caffeine alone, or music alone were eligible. Outcomes included rating of perceived exertion (RPE), Physical Activity Enjoyment Scale (PACES), Feeling Scale (FS), and heart rate (HR). Findings were synthesized descriptively by outcome and comparator, considering study-specific effect estimates, confidence intervals, and experimental conditions. Random-effects meta-analyses were retained as secondary exploratory summaries. Because fewer than 10 independent studies were available, meta-regression and formal assessment of small-study effects were not undertaken. Results: Five crossover studies involving 88 participants were included. Study-specific RPE estimates varied from large reductions to estimates close to the null or in the opposite direction. PACES point estimates favoured the combined intervention, but their magnitudes differed substantially in comparisons with placebo plus no music and caffeine alone. Feeling Scale and heart-rate findings also varied across studies. All four primary meta-analyses showed I2 values exceeding 90%, and the certainty of evidence was very low for all primary outcomes. Conclusions: The available evidence comprises five small crossover studies conducted in different populations and experimental settings. Study-specific findings suggest possible improvements in exercise enjoyment, while perceived exertion, affective valence, and heart-rate responses vary across studies. Neither the descriptive findings nor the secondary exploratory pooled estimates establish a stable, broadly applicable magnitude of intervention benefit. Given the very low certainty of evidence, no firm recommendations can be made regarding the use of caffeine combined with music across exercise populations and settings. Further adequately powered studies using clearly specified interventions and comparable outcome assessments are needed to determine which responses are reproducible and practically meaningful.