Sarcopenia is an age-related condition that is characterized by progressive and generalized loss of muscle mass and function. Exercise treatment has been the most commonly used intervention among elderly populations. We performed a systematic review and meta-analysis to evaluate the available literature related to the effects of exercise interventions/programs on muscle mass, muscle strength and physical performance in older adults with sarcopenia. We searched PubMed, Embase, Medline and the Web of Science for randomized controlled trials and controlled clinical trials exploring exercise in older adults with sarcopenia published through July 2019 without any language restrictions. Pooled analyses were conducted using Review Manager 5.3, with standardized mean differences (SMDs) and fixed-effect models. A total of 3,898 titles and abstracts were initially identified, and 22 studies (1,041 individuals, 80.75% females, mean age ranged from 60.51 to 85.90 years) were included in the meta-analysis. The exercise programs in the studies consisted of 30 to 80 min of training, with 1 to 5 training sessions weekly for 6 to 36 weeks. Muscle strength (grip strength SMD 0.57, 95% CI 0.42 to 0.73, p < 0.00001 and timed five chair stands SMD -0.56, 95% CI -0.85 to -0.28, p < 0.0001) and physical performance (gait speed SMD 0.44, 95% CI 0.26 to 0.61, p < 0.00001 and the timed up and go test SMD -0.97, 95% CI -1.22 to -0.72, p < 0.00001) showed significant improvement following exercise treatment, while no differences in muscle mass (ASM SMD 0.15, 95% CI -0.05 to 0.36, p = 0.15 and ASM/height2 SMD 0.21, 95% CI -0.05 to 0.48, p = 0.12) were detected. Exercise programs showed overall significant positive effects on muscle strength and physical performance but not on muscle mass in sarcopenic older adults.

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