Results of outcomes measures.

BackgroundExercising at a specific time of day has the potential to mitigate the negative effects of disrupted circadian rhythms caused by irregular work and sleep schedules on the development of chronic diseases. Afternoon/evening exercise is postulated to be superior to morning exercise for various health outcomes, but patient acceptance of timed exercise remains unclear. The aim of this systematic review was to assess the impact of exercise timing on patient-reported outcomes (PROMs).MethodsWe conducted a systematic review, following Cochrane and PRISMA guidelines (PROSPERO: CRD42022322646). We systematically searched databases including MEDLINE, SCOPUS, Embase, APA PsycInfo, CINAHL, and Web of Science, to identify studies which reported on PROMs related to timed exercise interventions: either acutely after a bout of exercise or following extended training (>1 month). Studies were included if they reported primary data from randomized or non-randomized experiments of timed exercise interventions (against any comparator), published in English until August 2023 and reporting on any PROM. Machine-learning software (AR Reviews) was used to aid in abstract screening. Subsequently, two independent reviewers reviewed the included full texts, extracted study details (participants, interventions, outcomes), and evaluated the risk of bias using Cochrane tools (ROB-2 and ROBINS-I). Exercise interventions were summarized using the TIDieR reporting method and results were presented in accordance with the Synthesis Without Meta-analysis (SWiM) guidelines for systematic reviews.ResultsSeventeen studies with 403 participants were included in the review. The interventions varied widely in exercise modality, duration, and participant characteristics, contributing to substantial heterogeneity in the findings. Most studies found no significant impact of exercise timing on PROMs. There was some inconsistency between studies for certain outcomes.DiscussionThe review suggests that there are no clear detrimental effects of afternoon or evening exercise on PROMs compared to morning exercise. However, the lack of homogeneity in study populations and small sample sizes resulting in low power for PROM outcomes are major limitations of the research in this field. If future research confirms the metabolic advantages of afternoon/evening exercise, this may be an acceptable alternative for individuals.

背景：在一天的特定时段进行运动，或可缓解不规律工作与睡眠节律导致的昼夜节律紊乱对慢性病发生发展的负面影响。现有研究假定，相较于晨间运动，午后/晚间运动对多项健康结局更具优势，但患者对定时运动的接受度仍不明确。本系统综述旨在评估运动时机对患者报告结局（patient-reported outcomes, PROMs）的影响。
方法：本研究遵循考克兰（Cochrane）协作网及PRISMA系统综述报告规范开展系统综述（注册编号：PROSPERO: CRD42022322646）。系统检索了MEDLINE、SCOPUS、Embase、APA PsycInfo、CINAHL及Web of Science等数据库，以识别与定时运动干预相关的患者报告结局研究，干预效应既包括单次运动后即刻的结局，也包括长期训练（≥1个月）后的结局。纳入标准为：报道定时运动干预（与任意对照相比）的随机或非随机实验原始数据，发表语言为英语且发表时间不晚于2023年8月，且报告了任意患者报告结局。本研究使用机器学习软件AR Reviews辅助完成摘要筛选。随后，由两名独立审阅者对纳入的全文文献进行评审，提取研究细节（研究对象、干预措施、结局指标），并采用考克兰偏倚风险评估工具（ROB-2与ROBINS-I）评价偏倚风险。运动干预采用TIDieR报告规范进行总结，研究结果按照系统综述无元分析合成（Synthesis Without Meta-analysis, SWiM）指南进行呈现。
结果：本综述共纳入17项研究，涉及403名研究对象。不同研究的运动方式、干预时长及研究对象特征差异显著，导致研究结果存在明显异质性。多数研究未发现运动时机对患者报告结局存在显著影响，部分结局指标的研究结果间存在一定不一致性。
讨论：本综述结果显示，相较于晨间运动，午后/晚间运动并未对患者报告结局产生明确的不利影响。然而，该领域现有研究仍存在两大主要局限：研究人群缺乏同质性，且样本量偏小导致患者报告结局的统计效力不足。若未来研究能够证实午后/晚间运动的代谢获益，其或将成为部分人群可接受的运动替代方案。