Relationships between Neighborhood Walkability and Objectively Measured Physical Activity Levels in Hemodialysis Patients

Background/Aims: Neighborhood walkability is associated with indicators of health in the general population. We explored the association between neighborhood walkability and daily steps in hemodialysis (HD) patients. Methods: We measured daily steps over 5 weeks using Fitbit Flex (Fitbit, San Francisco, CA, USA) and retrieved Walk Score (R) (WS) data by patient's home ZIP code (www. walkscore. com; 0 = poorest walkability; 100 = greatest walkability). Results: HD patients took a mean of 6,393 +/- 3,550 steps/day (n = 46). Median WS of the neighborhood where they resided was 28. Patients in an above-median WS (n = 27) neighborhood took significantly more daily steps compared to those (n = 19) in a below-median WS neighborhood (7,514 +/- 3,900 vs. 4,800 +/- 2,228 steps/day; p < 0.001, t test). Daily steps and WS were directly correlated (R = 0.425; p = 0.0032, parametric test; R = 0.359, p = 0.0143, non-parametric test). Conclusion: This is the first study conducted among HD patients to indicate a direct relationship between neighborhood walkability and the actual steps taken. These results should be considered when designing initiatives to increase and improvise exercise routines in HD populations. (c) 2018 S. Karger AG, Basel