Potential answers for "With genuine effort"

⭐⭐⭐⭐ ACTIVELY
⭐⭐ EKEOUT
⭐⭐ THE
⭐⭐ THEREALMCCOY
⭐⭐ HEAVED
⭐⭐ EXERT
⭐⭐ SCHLEPS
⭐⭐ HAMMERSOUT
⭐⭐ EKES
⭐⭐ HEAVE

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Realized   Primitive   Save one's breath, maybe?