The effect of prior education on the learning effect associated with the six-minute walk test in patients with congestive heart failure

A learning effect has been shown to be present in the repeated performance of the six-minute walk test and contributes to the variability of walk distance up to the third walk test. The purpose of this study was to see if education about the performance of the walk test could minimize the learning effect. It was hypothesized that education about the learning effect would decrease the learning effect. There were a total of 18 subjects (5 female and 13 male) with a mean age of 63.7+12.1 years that completed three standardized six-minute walk tests. The subjects were randomly assigned to either a Learning Effect Education (LEE) group or a Usual Care (UC) group. The LEE group was provided with education material about the learning effect approximately two days prior to their first walk test, with additional instruction immediately prior to their first walk test. The mean walk distances for the LEE group over the three walk tests were 1,248±297.4, 1,361.9±275.7, and 1,355.1+291.7 feet, respectively. Mean walk distances for the UC group over the three walk tests were 1,149.6+392.3, 1,123.6+427.5, and 1,209.9±368.7 feet, respectively. The hypothesis was tested and the repeated measures ANOVA showed a significant (p=0.033) interaction between the groups with respect to six-minute walk distance. A Bonferroni's post hoc analysis showed that mean walk distance (113.9+42.3 feet) increased significantly (p=0.048) from test one to test two in the LEE group. There was no significant difference between mean walk distance from test two and test three (6.8+31.1 feet) in the LEE group. In the UC group, there was no significant increase in mean walk distance from test one to test two (-26+42.3 feet), while there was a significant (p=0.04) increase in mean walk distance from test two to test three (86.3+31.1 feet). There was a significant difference between walk tests (p=0.011) with no significant difference between groups (p=0.333). In conclusion, the results from this study suggest that education may reduce the number of familiarization trials needed prior obtaining an accurate baseline six-minute walk test distance.School of Physical EducationThesis (M.S.