Is there a learning effect when the 6-minute walk test is repeated in people with suspected pulmonary hypertension?

The aim of the study was to determine if there was a difference in 6-minute walk distance (6MWD) when two 6-minute walk tests (6MWTs) were performed at the initial assessment prior to attendance at the pulmonary hypertension (PH) clinic and at the 6-month follow-up. Two 6MWTs were performed at both visits on a 32-m continuous track in the physiotherapy hospital outpatient setting using standard instructions and encouragement. Two hundred and fourteen participants completed two 6MWTs at the initial assessment and 71 participants at the 6-month follow-up (mean (standard deviation) age: 57 (16) years; body mass index: 27 (6) kg/m²). Using the better 6MWT, the mean distances walked were 429 (136) and 447 (130) m, respectively. There was a significant increase in 6MWD when a second 6MWT was performed at initial assessment (mean difference [95% confidence interval (CI)]: 19 m (14-24), p < 0.001) and at the follow-up (mean difference [95% CI]: 19 m (10-27), p < 0.001) but not in those who walked <300 m at the initial assessment (mean difference [95% CI]: 9 m (-5 to 22), p = 0.208). There were no adverse events during testing. Prior to attendance at the PH Clinic when people are asked to perform the 6MWT for the first time and at the 6-month follow-up, two walk tests should be performed in order to eliminate a learning effect and to ensure accuracy of measurement.