Aims and objectives: Research examining the effectiveness of resistance band exercises for improving physical and psychological dimensions among frail older adults has been inconsistent. We aimed to examine the effects of resistance band exercises for improving outcomes in frail older adults.

Background: To provide robust evidence regarding the effectiveness of resistance band exercises and explore other potential outcomes in frail older adults, a systematic review of RCTs remains necessary.

Design: Systematic literature review and meta-analysis were conducted in accordance with the PRISMA guidelines.

Methods: Four databases were searched. English language papers were retrieved from 2006 to 2020. Three reviewers reviewed the methodology of the selected studies using the Joanna Briggs Institute tool for randomised controlled trials. The pooled standardised mean difference was calculated using a random-effects model. Heterogeneity among pooled studies was assessed using the τ(2) , Q and I(2) statistics, and publication bias was evaluated using Egger's test and the visual inspection of funnel plots.

Results: A total of 15 studies met the eligibility criteria for this study. Overall, resistance band exercise reduced frailty after 24 weeks (SMD: -0.29; 95% CI: -0.55 to -0.03) and reduced depression after both 12 weeks (SMD: -0.19; 95% CI: -0.38 to -0.01) and 24 weeks (SMD: -0.30; 95% CI: -0.52 to -0.09). However, no significant effects were observed for frailty after 12 weeks, and no significant effects were observed for grip strength, leg strength, activities of daily living or quality of life at any time.

Conclusion: Resistance band exercise might be considered a viable strategy for frail older adults in the community or in long-term care facilities. More research implementing a standardised protocol remains necessary to identify the effects of different training volumes and the dose-response relationship for the very old and frail population.

Relevance to clinical practice: As a safe complementary intervention for frail older adults, health providers should consider resistance band exercises when caring for frail older adults because this intervention has clinical benefits.