INTRODUCTION
The COVID-19 pandemic has created a burden on public engagement in physical activity (PA). Traditional PA modalities in public settings may be redefined indefinitely, even postpandemic. Fitness and health care professionals are faced with an unprecedented obstacle in promoting PA to the public, given the norm of social distancing and restricted public gatherings. Attention is needed to reinforce the public awareness of the PA benefits, even in a remote setting. In short, PA, or exercise interchangeably, across all ages yields profound benefits, including but not limited to improving cardiovascular health, functional capacity, muscular fitness, mental health, and quality of life, and reducing all-cause mortality, risk factors for diseases, and risk of falling for older adults (1,2). Despite the apparent benefits of PA, public engagement is low. A recent review by Ozemek et al. indicated that physical inactivity is highly prevalent in the United States and worldwide in adults and adolescents (3). According to the Centers for Disease Control and Prevention, more than 15% of adults were physically inactive, defined as having absolutely no leisure-time PA during the past month in all U.S. states and territories (4). Moreover, according to the World Health Organization (WHO), one in four adults do not meet the recommendation of PA, and up to 5 million deaths per year could be averted if people around the globe were more active (5).
Globally, several commonly cited barriers to PA among adults and adolescents who are physically inactive include lack of transportation, time, facility access, knowledge, unwillingness to exercise with strangers, and financial cost of services (6–11). The COVID-19 pandemic has further disrupted PA engagement for many by limiting access to facilities and qualified fitness professionals. Temporary closure of many fitness facilities and enforced social distancing have resulted in limited access to regular PA or fitness professionals for consultation. Moreover, COVID-19 has resulted in additional PA decline, supported by Tison et al. (12), who report a worldwide decrease in step count with a range of 20% to 40% difference among major global cities since the start of the pandemic. These factors provide strong justification for fitness and health care professionals to advocate for and implement methods to increase PA levels, especially during such a difficult time.
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Sidebar: Valuable Resource
The following are helpful materials related to this article. The authors created a list of more than 200 equipment-free body weight exercises and video instructions for reference in the Supplemental Digital Content (https://links.lww.com/FIT/A201). In addition, an open-source, automatic exercise program generator app exclusively for designing a home-based body weight exercise program is currently being developed by this group. Public source codes are available for fitness professionals who are interested in reviewing the design algorithm at https://github.com/columbia-dsi/fit.
Globally, several commonly cited barriers to PA among adults and adolescents who are physically inactive include lack of transportation, time, facility access, knowledge, unwillingness to exercise with strangers, and financial cost of services. The COVID-19 pandemic has further disrupted PA engagement for many by limiting access to facilities and qualified fitness professionals.
Therefore, an intervention strategy is needed to overcome the aforementioned barriers and increase PA for all individuals. To accomplish this, body weight resistance, cardiovascular (aerobic), flexibility, and neuromotor exercise at home may be an effective intervention to increase PA levels given the convenience and ease of maintaining social distancing and following pandemic-related quarantine regulations (13,14). The benefits of regular body weight training include improvements in body composition, blood glucose levels, insulin sensitivity, and blood pressure (15–17). Moreover, studies of animal models and elite athletes show that higher skeletal muscle mass resulting from continued exercise may improve immune system function and vaccine response (18,19) and may minimize the risks associated with COVID-19. The figure lists potential benefits of home-based exercise.
Figure: Infographic for the benefits of home-based body weight exercise.
To date, there is minimal literature available to help make recommendations exclusively for body weight home-based exercise programming. Therefore, the purpose of this article is to provide a practical strategy to develop a comprehensive and well-rounded body weight home-based exercise program with emphases on exercise selection and program design principles. Information in this article will help guide fitness professionals with body weight exercise programming and serve as valuable educational material for an individual seeking a comprehensive home-based exercise program.
DESIGNING AN EFFECTIVE AND COMPREHENSIVE BODY WEIGHT HOME EXERCISE PROGRAM
Preexercise Safety Tips
Before starting exercise, it is important to administer a preparticipation health screening to determine if medical clearance is necessary (20). A thorough initial assessment includes the client completing the 2021 Physical Activity Readiness Questionnaire for self-screening (21) and the fitness professional's use of the ACSM preparticipation screening algorithm (20). Further consultation from health care professionals is necessary for medical clearance if the prescreening indicates such action (20). Although exercise is being performed in a home setting, the fitness professional must still use general exercise termination criteria, such as stopping exercise with the onset of angina or angina-like symptoms, excessive fatigue, shortness of breath, claudication, and/or dyspnea (20). The fitness professional must ensure all exercises are performed with proper form and technique with each client.
As a general recommendation for healthy adults and adolescents and especially persons with known hypertension, breath holding (Valsalva maneuver) is discouraged because of its correlation with the increase of hemodynamic profiles (22). A correct breathing pattern includes exhaling during the concentric contraction and inhaling during the eccentric contraction or maintaining a regular breathing pattern during resistance training and maintaining a normal and consistent breathing pattern during cardiovascular, neuromotor, and stretching exercises (20,23).
A warm-up and cool-down should be performed before and after each exercise session, respectively. The warm-up typically consists of light-intensity rhythmic body movement (i.e., walking and jumping jacks) for 5 minutes followed by 5 to 10 minutes of dynamic stretching of the major muscle groups (20). For the cool-down, lower intensity rhythmic body movement followed by static stretches and deep breathing is recommended.
When exercising at home, it is important to adhere to several safety recommendations. The environment must be clear of obstructions, uneven surfaces (i.e., rug to hardwood flooring), or tripping hazards. The client should ensure that there is sufficient space for jumping or leaping exercises and that appropriate footwear and exercise mats are used to minimize slipping, tripping, or falling. Attempts to minimize noise disruption for neighbors should be considered when engaging in heavy exercise. Both the client and the fitness professional need to ensure a camera setup that allows for clear visibility of each person when engaging in interactive online training sessions. The client's overall training space needs to be inspected to minimize any potential hazards, and the fitness professional needs to have a quiet and clean workout environment with sufficient light sources for demonstration. An additional device to record the client's activities is recommended. As if in an in-person training, all legal and supporting documentation must be obtained before training sessions and in accordance with ACSM's recommendations (20). Record each client's emergency contact and address in case there is a need to call advanced medical personnel for assistance. For those clients who may need additional supervision, the fitness professional should communicate with another person who lives with the client (i.e., family member or caregiver) and provide details on the exercise program or signs of distress.
Exercise Components, Selection, and Programming
A comprehensive plan focuses on the health-related components of fitness, including muscular strength and endurance, cardiorespiratory endurance, flexibility, neuromotor fitness, and body composition (20). These components can be achieved through four basic principles of specificity, overload, progression, and variation that are typically incorporated into the FITT-VP model (24) (Table 1).
TABLE 1 -
FITT-VPP Recommendation for Home-Based Body Weight Exercise Development
| FITT-VPP |
Resistance Exercise |
Aerobic Exercise |
Flexibility |
| Frequency |
● Train major muscle groups |
● 3–5 days per week |
● Static stretch each major muscle group for 2–3 days per week |
|
● 2–3 days per week |
● Dependent on intensity and time availability |
● Dynamic stretch as part of warm-up before body of exercise |
| Intensity |
● OMNI RPE 6–8 (moderate to vigorous intensity) on a 0–10 scale for novice and intermediate exercisers to improve strength |
● Borg RPE of 12–17 (moderate to vigorous intensity) on a scale of 6–20 for most adults |
● Static stretching should be performed with middle discomfort in the belly of the muscle |
|
● OMNI RPE of 7–9 (vigorous to very vigorous intensity) for advanced exercisers to improve strength |
● Borg RPE of 9–11 (light intensity) for beginners and deconditioned individuals |
● Dynamic stretching should be performed with full range of motion |
|
● OMNI RPE of 1–4 (very light to light intensity) for older adults beginning exercise to improve strength |
|
|
|
● Tiredness, not exhaustion (OMNI RPE of 10), should be felt when approaching the last few repetitions set for the proper overload |
|
|
| Time |
● Depending on specific training goal, 20–45 minutes per session is recommended |
● 20–40 minutes per day for conditioning phase with moderate to vigorous intensity to meet the general recommendation |
● Static stretch: holding 10–60 seconds each set for each specific muscle group; this can be accomplished in one individual set or several bouts |
|
● Greater number of sets, repetitions, and exercises will increase session duration |
● Duration is dependent on intensity; greater intensity results in shorter duration |
● Dynamic stretch: no specific duration is identified, but the goal is to it into the warm-up. |
|
|
● Continuous session, one interval session, or in multiple sessions of ≥10 minutes to accumulate the desired duration |
|
|
|
● ≥10 minutes per day for those with time constraint to receive benefits from exercise |
|
|
|
● <10 minutes per day for very deconditioned individuals to receive benefits from exercise |
|
| Type |
● Focus on body weight multijoint exercises, such as push-ups, squats, etc. |
● Body weight aerobic full-body exercise program can include plyometric exercises for increased intensity, or it can be combined with resistance exercises in an interval circuit |
● Series of stretches focused on various muscle groups |
|
● Exercises involving each major muscle group are recommended |
|
● Other activities, such as yoga and tai chi, may also provide improved flexibility and range of motion |
| Volume |
● 8–12 repetitions for muscular strengthening exercises |
● Group into sets or circuits as if traditional resistance training exercises |
● 60 seconds for each flexibility exercise |
|
● 13–20 repetitions for muscular endurance or fat burning |
● Working duration, rather than repetitions, should be focused; for example, three sets of jumping jacks with 45 seconds for each set. |
● No specific weekly volume is identified but stretch can be performed anytime in a home-based setting |
|
● Minimal 2 sets each session for each muscle group |
● MET·min−1 consumption each week; a volume of 500–1000 MET·min−1 per week is recommended |
|
|
● 2 times each week for a total of 4 sets for each muscle group |
|
|
| Pattern |
● Rest 1–3 minutes between sets |
● Rest time should be controlled at a minimum to allow continuous exertion; typically, it should be less than 30–60 seconds between exercises |
● A very short rest can be taken between repetitions from 10 to 30 seconds |
|
● An alternate push-pull is recommended; as such, the opposing muscle group can receive enough rest between exercises for a shorter rest time |
|
|
| Progression |
● If one can perform targeted repetitions with ease, either increase repetitions or change to a more advanced exercise. |
● Select more advanced exercises (e.g., exercise involved plyometric maneuver), reduce the rest time between sets, increase the duration for each set, or increase the movement velocity |
● Progression is not identified for the stretch, but the authors suggest gradually increasing the range of motion over time with the improvement of flexibility |
|
● Reducing movement velocity to increase intensity level |
|
|
Adapted from
ACSM's Guidelines for Exercise Testing and Prescription, 11th edition (
20).
A comprehensive plan focuses on health-related components of fitness, including muscular strength and endurance, cardiorespiratory endurance, flexibility, neuromotor fitness, and body composition. These components can be achieved through four basic principles of specificity, overload, progression, and variation that are typically incorporated into the FITT-VP model.
An individual's current PA and exercise level as a baseline measure can be used to determine the proper exercise selection, intensity, and volume. Instruments such as the International Physical Activity Questionnaire (IPAQ), the Godin Leisure-Time Exercise Questionnaire, and the Yale Physical Activity Survey (YPAS) (25–27) can be used to determine an individual's current PA level before selecting proper exercise. The fitness professional must interpret the results from the IPAQ or YPAS, along with other screening or assessment data collected, to determine an appropriate starting intensity for the client (20). In the Supplemental Digital Content (https://links.lww.com/FIT/A201), the authors grouped more than 200 body weight exercises with instructional videos by type, specific muscle groups trained and suggested exercise levels (e.g., beginner, intermediate, and advanced) as a reference. The following sections provide exercise recommendations that are aligned with the widely accepted FITT-VP for apparently healthy individuals. It is important to understand that chronic disease and disability states and current fitness levels will require individualized exercise programming in both the home exercise and the virtual environments. The fitness professional is expected to be familiar with each client's needs and the general exercise modifications required for specific conditions and settings (20,28).
Resistance Exercise at Home for Muscular Strength and Endurance
In a home-based setting, body weight resistance exercises are less plyometric, more static, and focused on individual muscle group rather than exercises that engage full-body movements. Training is recommended 2 to 3 days per week for each major muscle group using 2 to 4 sets of 8 to 25 repetitions depending on the specific goal. Each muscle group should receive the same number of exercises to create balanced muscular strength and endurance. When designing a program, an alternating exercise order is recommended targeting opposing muscle groups to maximize the time efficiency of the session. Resistance training exercise sessions can be organized into either 2 to 3 full-body days for those who are time constrained or a split routine (upper and lower body days) when time permits a longer exercise duration.
Percentage of one-repetition maximum is not a practical way to determine the intensity for body weight resistance exercise. Use of the OMNI–Resistance Exercise Scale (OMNI-RES) to monitor resistance training intensity is a feasible option for gauging intensity associated with body weight exercise (29). Tiredness, not exhaustion, is appropriate when approaching the last few repetitions of the set for adequate overload. Based on the individual's goal, the authors suggest 8 to 12 repetitions for muscular strengthening exercises and 13 to 25 repetitions for muscular endurance with a rest duration of 2 minutes between sets. The following tips can be used to manipulate the intensity of body weight resistance training and make the exercises more challenging:
- Focus on slow and controlled movement and alternate the tempo of exercises to prolong the muscle tension. For example, a 3:1 tempo push-up with a 3-second eccentric contraction, followed by a 1-second concentric contraction.
- Manipulate the leverage of movements so that greater muscle torque is required. For example, elevate the position of the feet and use wider hand positioning while doing regular push-ups.
- Progression from bilateral to unilateral exercises can be used to increase complexity and intensity of select exercises. For example, transitioning from a bilateral squat to a single-leg squat with a secure chair.
- The authors have provided supplemental materials that group exercises into various suggested levels of difficulty for progression over the course of time.
Cardiovascular Exercise at Home for Cardiorespiratory Health and Function
Unlike the traditional modalities such as jogging, running, or cycling, using body weight to do aerobic training at home also involves discrete exercises similar to body weight resistance training. However, these exercises often involve full-body motions or plyometric movements that are interval in nature and can be grouped with body weight resistance. Although aerobic exercises should be performed three to five times a week, the traditionally recommended duration (e.g., 150 minutes for moderate-intensity aerobic exercise) is not practical for body weight aerobic exercises in a home setting. Thus, it is better for the fitness professional to use metabolic equivalents per minute (MET·min−1) as they can provide a more accurate estimate of intensity, volume, and caloric expenditure (20). The fitness professional should work with the client to accumulate the recommended 500 to 1000 MET·min−1 per week. Specifically, a perceived rating of 12 to 17 on a Borg rating of perceived exertion (RPE) scale is categorized as moderate to vigorous intensity and corresponds to 4–10 METs (20). To calculate the total MET·min−1 for an aerobic session, simply multiply the duration of the session by the corresponding MET level. For example, a 20-minute body weight aerobic training session at moderate intensity (~5 METs) is equivalent to 100 MET·min−1 for that session. The fitness professional also can provide an explanation of the simple “Talk Test” to the client to assist them in self-determining if their workload is moderate or vigorous intensity. For example, if the client is unable to have a conversation during the body weight exercise routine, they are likely exercising in the vigorous-intensity domain.
Clients also can monitor body weight aerobic exercise intensity by using RPE during PA (30). Normally, a rating of <9, 9 to 11, 12 to 13, and 14 to 17 corresponds to very light, light, moderate, or vigorous intensity, respectively. Because of the movement patterns associated with body weight aerobic exercise, it is possible that this activity will result in higher intensity compared with the traditional modality; even relatively short sessions can result in a greater dose–response for health gains. For beginners, light intensity also can yield apparent health benefits (31).
Greater emphasis on time for each set, rather than the number of repetitions, is recommended for this mode of exercise. Individuals can perform an aerobic exercise, such as jumping jacks, for 45 seconds continuously with 15 seconds of rest. The intensity can be manipulated by varying the speed of the movement. The faster the speed, the higher the exertion and intensity of exercise. Progression can be achieved by selecting more advanced exercises that incorporate plyometric movements, by increasing movement velocity and duration of movement, or by reducing rest time. The rate of progression is dependent on each client's fitness level and the ability to perform exercises with correct form and technique.
Flexibility and Neuromotor Exercises at Home for Injury Prevention and Functional Fitness Improvement
Flexibility exercise in a home setting includes dynamic and static stretching. An added benefit of body weight exercises is that they can serve the purpose of dynamic stretching. Before an exercise session, the warm-up goal is to move parts of the body in the same movement patterns as the exercise session and to gradually increase the range of motion. This can be achieved by performing a variety of light-intensity exercises such as toe touches, jumping jacks, etc., then progressing to higher intensity movements as described previously. Similar to static stretching, dynamic stretching yields health benefits such as increasing body temperature for injury prevention, increasing elastic profiles of muscles and tendons, and enhancing overall movement coordination (32).
Although static stretching typically occurs at the end of the session, clients should consider stretching at other convenient times like watching TV or taking sitting breaks from desk work. It is recommended that each muscle group accumulates a total of 60 seconds of static stretching. This can be achieved by performing multiple sets.
In addition to flexibility exercises, neuromotor fitness has been recognized as an important component of well-rounded exercise programs for individuals of all ages. In terms of neuromotor exercise, motor skills training like agility, balance, and coordination training are often involved. For exercise programming, the fitness professionals can incorporate various types of balance, agility, and coordination training into regular training routines. Many single-stance exercises like lunges, single-leg reverse deadlifts, or step-ups are good examples of neuromotor training when using body weight. Core stability training like using a BOSU® trainer also has been a popular option for neuromotor fitness improvement and can be easily done at home.
For older adults, balance training also is important for fall prevention. Structured training that manipulates body stance, center of mass, and proprioceptive ability can be included during the cool-down or at a dedicated time. Alternate forms of flexibility and neuromotor exercises, such as tai chi, yoga, etc., are excellent options and may have the added benefit of relaxation and stress management for all populations (20,33).
Examples of the Weekly Home-Based Body Weight Exercises Training Regimen
Table 2 shows a sample pattern of program design for an individual transitioning from beginner to advanced levels. It provides a good example of the basic framework mentioned above to develop a comprehensive training routine with a variety of body weight training intensities. The program is intended to create a balance between muscular and cardiorespiratory fitness for a person who can complete four 30- to 45-minute training sessions per week. Intensity and progression are shown by changing the exercise selected based on the suggested difficulty level and schemes of aerobic training. A more comprehensive weekly program sample is available in the second Supplemental Digital Content (https://links.lww.com/FIT/A202).
TABLE 2 -
Exercise Sample Programs for Three Exercise Levels
|
Beginner |
Intermediate |
Advanced |
| Warm-up |
(1) Walking back and forth, (2) arm circles, (3) back walking, (4) leg pendulum, (5) side shuffles
|
| Cool-down and flexibility training
a
|
(1) Chest stretch, (2) low-back stretch, (3) hamstring stretch, (4) calf stretch, (5) figure 4 stretch
|
| Neuromotor training#
|
(1) Seated chair lean, (2) upright wide stances
|
(1) Seated chair lean with armmoves, (2) tandem walk forward and backwards
|
(1) Closed-eye seated chair lean with arm and leg moves, (2) Tandem walk forward and backward with obstacles
|
| Days 1 and 3: resistance training |
| Exercises |
(1) Wall push-ups, (2) chair squats, (3) towel rows, (4) curl-ups
|
(1) Regular push-ups, (2) sumo squats, (3) door frame rows, (4) toes touch
|
(1) Feet-elevated push-ups, (2) Bulgarian split squat, (3) reacher rows, (4) scissors
|
| Schemes |
3 sets × 12 reps for the first three major muscle exercises, 2 sets × training to failure for the core exercise
Extremely inactive individuals may start with 1–2 sets for each exercise |
| Estimated volume |
30–45 minutes, 6 sets for the major muscles group and 4 sets for the core per week |
| Days 2 and 4: cardiovascular training |
| Exercises |
(1) Jumping jacks, (2) sprinter's arm swing, (3) power skips, (4) slam, (5) running in place
|
(1) Mountain climbers, (2) halo slam, (3) high-knee run, (4) plank-to-knee tap, (5) alternating fast feet
|
(1) Super skaters jumps, (2) T-rotation, (3) lunge jump, (4) burpees, (5) breaker dance
|
| Schemes |
2 circuits, 60 seconds for each exercise, and 60-second rest between exercises |
2 circuits, 75 seconds for each exercise, and 45-second rest between exercises |
2 circuits, 90 seconds for each exercise, and 30-second rest between exercises |
| Estimated volume |
20–30 minutes, 500–800 MET·min−1 per week based on the perceived exertion rating |
Video instructions are embedded as the hyperlinks for each exercise.
a Complete some very light-intensity exercises such as those in the warm-up followed by these static stretching exercises.
Virtual Personal Training in a Remote Setting
In recent years, virtual online training has become a popular PA modality among the public. This type of training creates a home-friendly environment for selective populations to maintain physical fitness with minimal equipment needed and is less time consuming. An effective virtual training program led by a qualified fitness professional could potentially overcome many PA barriers because of the challenges associated with transportation, facility access, knowledge, unwillingness to exercise with strangers, and high financial cost of in-person services.
Moreover, the COVID-19 pandemic has resulted in a need for exercise landscape renovation with the increasing demand for virtual online training at home, according to the 2021 ACSM fitness trends survey (34). Traditional face-to-face service may not be practical in many settings during the pandemic and possibly afterward. On the other hand, when educating clients about PA in a remote setting, the power of technology can serve as a platform to provide opportunities that promote and improve PA and offers a solution to help people stay physically active while maintaining pandemic-related self-quarantine. Virtual consultation and personal training services can provide a bridge in this remote environment between fitness professionals and clients. When educating clients, the authors recommend using eHealth apps to help clients actively engage in PA in a remote setting. A fitness-promoting eHealth app features client fitness education, motivational changes, diet and body composition management, and other capacities that can promote overall wellness.
Moreover, the COVID-19 pandemic has resulted in a need for exercise landscape renovation with the increasing demand for virtual online training at home, according to the 2021 ACSM fitness trends survey. Traditional face-to-face service may not be practical in many settings during the pandemic and possibly afterward.
Evidence also has shown that eHealth apps increase PA by motivating users and providing structured PA information (35). Encouraging clients to use these apps to monitor their daily activity levels and to tailor their exercise programs in a remote setting is recommended. Many commercially available apps feature a wide array of detailed video instructions of body weight and other forms of exercise that will assist clients in completing their prescribed exercise regimens.
SUMMARY
Although much attention has been placed on the COVID-19 pandemic, physical inactivity is perhaps a more severe threat to health. The WHO has identified physical inactivity as the fourth leading risk factor for global mortality (36). Interventions are needed to combat not only COVID-19 but also a persistent pandemic of physical inactivity (37). To accomplish the goal of reducing physical inactivity, the authors value body weight exercise at home as a viable option that can solve the common barriers of time constraint, lack of knowledge, facility accessibility, etc. Exercise at home features little to no prior exercise knowledge, provides maximal convenience, and promotes self-comfort. Remote exercise training in a private setting, such as one's home, may be a norm for future fitness trends, given many of the aforementioned benefits. With the added power of virtual training technologies, the home can become the gym for the future.
BRIDGING THE GAP
The main purpose of this article is to reinforce fitness professionals' fundamental knowledge of exercise options to help clients modify and apply basic body weight movements at home. Because of the COVID-19 pandemic, this idea has become a common practice. Additional materials provided will offer valuable information on the basic framework and examples of exercise programming specifically for home-based exercise settings. Extensive video instructions of body weight exercises also are demonstrated in this article for fitness professionals to suggest a home-based video training option for client education.
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