Effectiveness of exercise intervention on muscle mass, muscle strength, and physical function among postmenopausal women with sarcopenia: a systematic review and meta-analysis

Background: Sarcopenia is highly prevalent among postmenopausal women due to hormonal changes and aging, and is associated with adverse health outcomes. Exercise has been proposed as a key strategy to mitigate sarcopenia; however, its effectiveness in this population remains inconclusive. Objective: To systematically evaluate the effects of different exercise modalities on muscle mass, muscle strength, and physical function in postmenopausal women with sarcopenia. Methods: A systematic search was conducted across six electronic databases from inception to April 1, 2025. Randomized controlled trials evaluating exercise interventions in postmenopausal women with sarcopenia were included. Primary outcomes were muscle mass, muscle strength, and physical performance. Meta-analyses were performed using RevMan and Stata. Results: A total of 17 RCTs involving 744 postmenopausal women with sarcopenia were included in this systematic review. The pooled analysis revealed that exercise interventions significantly improved skeletal muscle mass index. Additionally, significant improvements were found in muscle strength, including grip strength and knee extension strength. Physical function also improved, as evidenced by improvements in gait speed, the Timed Up and Go test, and single-leg stance. No significant differences were observed for body mass index (BMI) between intervention and control groups. Conclusions: Exercise interventions were associated with improvements in muscle mass, muscle strength, and physical function in postmenopausal women with sarcopenia. These findings support the integration of structured exercise programs into clinical practice to improve sarcopenia-related outcomes in this population. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024608200, identifier: CRD42024608200.