Lower 6-minutes walk test result and presence of cardiovascular risk factors linked to healthcare facility visits of pilgrims: the importance of fitness in hajj pilgrimage

Abstract

Abstract Background Hajj pilgrimage, a mandatory religious practice for the Muslims, is a physical rite attributed heavily on the fitness of the participants due to increased workload in performing its activities. The 6-minutes walk test is a simple assessment to predict candidates’ fitness level. Objective We sought to determine the association between pilgrim candidate fitness level, determined by 6-minutes walk test result during predeparture preparation, as well as pre-existing potential risk factors of hajj pilgrim participants. Method In this retrospective cohort, we obtained the data of 2022 pilgrimage participants from Indonesian Ministry of Religious Affairs, consisting of demographic characteristics, anthropometric indexes, medical history, physical examination, and functional exercise capacity predicted by 6-minute walk test conducted during pre-departure preparation. Baseline demographic, bivariate tests for each variable, and multivariate test were analyzed by IBM SPSS 26. Result There was significant correlation between age of ≥60 (p < 0.001), hypertension (p < 0.001), diabetes mellitus (p < 0.001), 6-minutes walk test (p < 0.001), smoker status (p = 0.008), high LDL-C (p = 0.026), obesity (p =0.033), female sex (p = 0.043) and healthcare visit episode of pilgrims. The risk ratio value for low result group of 6-minutes walk test (< 500 meters) against outpatient incidence during hajj period was 1.08 (95% CI; 1.04 -1.12). It indicated that the inability of reaching >500 meters in 6-minutes walk test is related to outpatient incidence by 1.08 times. Conclusion There is a slight increase in healthcare visit incidence in pilgrims with low result of 6-minutes walk test. The 6-minutes walk test, a simple and reproducible assessment of fitness level, may provide useful information to improve preparation of pilgrimage.