Exploring the Learning Effect of the 6-minute Walk Test in Patients with Arterial Hypertension

Kaoutar Kabbadj, Faiza Aziouaz, Abdelkader Jalil El Hangouche

Abstract


Background: The 6-minute walk test (6MWT) is widely used for assessing functional capacity in various clinical populations. However, the presence and extent of a learning effect in hypertensive patients remain insufficiently explored, particularly in Moroccan populations. Objective: This study aims to evaluate the learning effect in the 6MWT among hypertensive patients and to identify potential predictors influencing performance variation across repeated tests. Methods: This is a cross-sectional study in which 90 hypertensive patients completed three consecutive 6MWTs on the same day, with a 30-minute rest period between each trial. The distance walked was measured in meters during each test, while heart rate, blood pressure, and perceived exertion (Borg scale) were recorded before and after each test. Effect sizes were calculated to assess the magnitude of performance changes. Regression analyses were performed to explore potential predictors of the learning effect. Results: A significant improvement in walking distance was observed between the first and second trials (5.11% increase; Cohen’s d = -1.57; p < 0.001), with no further significant changes between the second and third trials (Cohen’s d = 0.15; p = 0.152). The Kruskal-Wallis test analysis revealed that baseline walking distance significantly influenced the learning effect (p < 0.001, η² ≈ 0.210). Among all variables examined, baseline walking distance emerged as the only significant predictor, with participants who walked less than 300 meters during the first 6MWT trial exhibiting a markedly smaller improvement between trials compared to those with higher initial performance. No significant associations were found with other clinical or demographic factors (p for gender = 0.501; p for weight = 0.334; p for height = 0.387; p for BMI = 0.524; p for physical activity = 0.966). Conclusion: The results demonstrate a clear learning effect in hypertensive patients performing the 6MWT, stabilizing after the second trial. These findings underscore the importance of conducting at least two 6MWTs to accurately assess this population’s functional capacity. Repeated trials in routine practice may help avoid underestimating patients’ true exercise tolerance, thereby aiding more tailored rehabilitation planning.

Keywords


Walk Test, Hypertension, Exercise Test, Physical Fitness

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References


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DOI: https://doi.org/10.7575/aiac.ijkss.v.13n.2p.30

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