Exercise delivers numerous physical and psychological benefits to patients, including both the prevention and treatment of disease. However, many patients do not obtain the recommended 150 minutes of weekly moderate activity.¹ In fact, some may not register this amount of activity on a monthly basis. There are numerous reasons why people choose not to exercise, including a lack of time, interest, finances, proper workout facilities, or external support.

The transportability of mobile phones means patients can use them while exercising, and numerous fitness applications can help address each of the above excuses. This article focuses on six apps that are free and do not require exercise equipment. All earned top ratings when reviewed using FPM's “SPPACES” criteria.

J&J OFFICIAL 7 MINUTE WORKOUT

J&J Official 7 Minute Workout teaches users a high-intensity full-body work-out that they can complete within seven minutes.

Source: Johnson & Johnson Health and Wellness Solutions Inc.

Platforms available: Android 4.4 or later (https://bit.ly/2tyazQr); iOS 10.0 or later for iPhone, iPad, and iPod touch (https://apple.co/2tpMudN).

Pertinence to primary care practice: A major barrier patients cite for not exercising is a lack of time. But exercising for as little as seven minutes per day has been shown to make visible changes. In one study, normal weight individuals who followed the seven-minute workout experienced a 4-centimeter reduction in hip and waist circumference over three weeks without changing their eating habits.² Another study found that physically inactive participants maintained enthusiasm for exercise better when doing high-intensity functional training than when doing moderate activity.³

Authoritativeness/accuracy/currency of information: The app was created by the director of exercise physiology at Johnson & Johnson Human Performance Institute. It has 22 programmed workouts and the option to create custom workouts that last up to 32 minutes using 72 different exercises. Users can like and dislike certain exercises, set a fitness level, and log their motivation level for exercise. The app can then use this information to create personalized Smart Workouts. Users can also set workout and inactivity reminders as well as track workouts and share them with friends on Facebook and Twitter. For iPhone users, the app can integrate information with Apple Health. The app was last updated in February 2018 (Android) and June 2018 (iOS).

Cost: Free.

Ease of use: The app's interface during workouts is phenomenal; users can listen to their own songs, view a workout timer, or watch a coach perform the exercise they are currently doing. The coaching is both appropriate and helpful. J&J Official 7 Minute Workout is available in English only.

Sponsor: Johnson & Johnson Health and Wellness Solutions Inc.

Rating:

This is an ideal app for the busy or inactive patient who wants to start incorporating exercise into his or her routine.

30 DAY FITNESS CHALLENGE

30 Day Fitness Challenge provides a template for making new exercise and dietary habits.

Source: Leap Fitness Group.

Platforms available: Android 4.0 or later (http://bit.ly/2KBz59G); iOS 8.0 or later for iPhone, iPad, and iPod touch (https://apple.co/2Fv6Rur).

Pertinence to primary care practice: Many patients lack the impetus to start an exercise program because they are unsure how to begin or what to do. They may need exercises they can do at home because they can't afford a personal trainer or a gym membership. The 30 Day Fitness Challenge is based on the premise that it takes 30 days to form a new habit.

Authoritativeness/accuracy/currency of information: The app was created by a professional fitness coach and has 30 different 30-day workout routines that range in difficulty from beginner to professional. The routines can involve full-body exercises or focus on specific areas, such as abs, arms, legs, or buttocks. The app's additional features include instructional videos for each exercise, optional daily workout reminders, weight tracking, the ability to share with friends on social media, and data integration with Apple Health or Google Fit. The app was last updated in August 2018.

Cost: Free, but the app includes ads, which can be removed for a $2.99 upgrade.

Ease of use: The app integrates multiple features in a logical and seamless manner. The narrator is quite robotic (similar to Siri) and could be improved. The content is available in English and multiple other languages.

Sponsor: Abishkking Limited.

Rating:

This app is great for patients who want a step-by-step approach to making habit changes.

CHARITY MILES

Charity Miles converts miles walked into money for the user's charity of choice.

Source: Charity Miles LLC.

Platforms available: Android 4.0 or later (http://bit.ly/2tQRFDU); iOS 10.0 or later for iPhone, iPad, and iPod touch (https://apple.co/1jJ6sah).

Pertinence to primary care practice: Walking is one of the best exercises we can recommend to our patients, but some patients have trouble taking time for themselves and need an incentive. This app provides that while also potentially improving their health. A systematic review of 27 studies found that app-based interventions improved physical activity in 14 of 21 trials and decreased sedentary behavior in two out of five studies.⁴

Authoritativeness/accuracy/currency of information: During app setup, users can choose one of 40 charities to receive contributions, which they can change at any time. The money comes from companies who advertise within the app. When the user walks, the app automatically logs the miles traveled, time spent exercising, and miles per hour. Users can also join a team to walk with and take photos to accompany each workout. Combined, users have traveled more than 100 million miles and raised more than $2.75 million for charity. Charity Miles has won awards from a number of fitness publications and other organizations. The app was last updated in June 2018.

Cost: Free.

Ease of use: The initial setup takes a minute or so and is as easy as texting. After that, it is quick to navigate with minimal menus. To get credit for walking, users must walk at least a tenth of a mile. Some users have noted that the app decreases battery life and may not always track miles appropriately. The advertisements are well placed and do not affect the functionality of the app. The content is available in English only.

Sponsors: Various.

Rating:

This is the perfect app for motivating people who have trouble taking time for themselves to exercise.

NIKE+ RUN CLUB

Nike+ Run Club is an app for runners to log their duration, distance, and speed, gain motivation by listening to Nike athletes and coaches, and be involved in an online running community.

Source: Nike Inc.

Platforms available: Android 4.4 or later (http://bit.ly/2tF3I7J); iOS 10.0 or later for iPhone, iPad, Apple Watch, and iPod touch (https://apple.co/2tHUZBT).

Pertinence to primary care practice: Many people find exercising with others helpful to stay motivated. One study found that combining an exercise mobile app with daily videoconferencing for eight weeks among inactive, healthy mothers resulted in a weekly increase of 50 minutes of moderate physical activity and 19 minutes of vigorous activity.⁵

Authoritativeness/accuracy/currency of information: Users can choose to do a quick start run, listen to a guided running workout by Nike athletes or coaches, or follow their own running plan. The app tracks and stores all runs and records, and it can be integrated with Apple Health. Users can gain trophies and badges within the app and can participate in weekly and monthly distance challenges. The app was last updated in July 2018.

Cost: Free.

Ease of use: The app is easy to navigate but does experience some lag time between menus. Also, the global positioning system (GPS) function can glitch and not track runs accurately. The content is available in English and multiple other languages.

Sponsor: Nike Inc.

Rating:

This is a great app for runners interested in more closely tracking their running while being part of a larger online community.

ZOMBIES, RUN!

Zombies, Run! combines a role-playing game with a story to motivate users to run more and faster.

Source: Six to Start.

Platforms available: Android 5.0 or later (http://bit.ly/2KwR8Be); iOS 11.2 or later for iPhone, iPad, and iPod touch (https://apple.co/2NawUfe).

Pertinence to primary care practice: Sometimes exercising can be boring. This app keeps users interested by incorporating a story into their runs that changes based on their reactions.

Authoritativeness/accuracy/currency of information: The app, featuring a storyline by award-winning novelist Naomi Alderman, has more than 1 million players. As the user walks, jogs, or runs, he or she goes deeper into the story. The farther the user travels, the more virtual supplies he or she accumulates to defend against a zombie outbreak. The app includes more than 300 missions, which can be played both indoors and outdoors. The first four missions are free with the ability to unlock one extra mission each week. The paid version unlocks all story missions with the ability to include interval training. The app's data is stored online, and users can share their runs with one another. The app was last updated in July 2018.

Cost: Free; additional story missions are immediately available for a subscription of $3.99 per month or $24.99 per year.

Ease of use: The audio story plays between songs from the user's own playlist. One drawback of using the app is it tends to drain the battery of the device quickly. Some content is not appropriate for children younger than the age of 12. At times, the GPS can malfunction and affect gameplay.

Sponsor: Six to Start.

Rating:

This is a great app for people who want something different to spice up their workout routine.

C25K – 5K RUNNING TRAINER

C25K (Couch to 5k) provides a walking/running program to help inactive patients increase their cardiovascular stamina.

Source: Zen Labs LLC.

Platforms available: Android 4.4 or later (http://bit.ly/2NcaLgG); iOS 10.0 or later for iPhone, iPad, and iPod touch (https://apple.co/2MyXugU).

Pertinence to primary care practice: Runners who use a self-devised training program are more likely to injure themselves than those who use a structured program.⁶ This app provides that structure for patients who are just getting started with a running program.

Authoritativeness/accuracy/currency of information: C25K includes an eight-week program that includes 30-minute workouts three days per week. The pro version can track calories burned and distance for each workout and users can share that data on Facebook, Twitter, and Instagram. The data can automatically transfer to MyFitnessPal, Apple Health, and Google Fit. The app has been featured by a number of media outlets. It was last updated in May 2018 (iOS) and July 2018 (Android).

Cost: Free; the pro version, which also removes ads, costs $4.99; accessing an in-app music playlist requires a subscription of $4.99 per month or $49.99 per year.

Ease of use: The app is very easy to use. Once the user presses the start button, the audio coach simply tells him or her what to do and for how long. The user can also set up alerts as a reminder to exercise.

Sponsor: Zen Labs LLC.

Rating:

This is a great app for the inactive patient who wants to take up running.