Using Geospatial Analysis to Determine the Proximity of Community Gyms for a Population-based Cohort of Young People with Cerebral Palsy

Purpose:To quantify a perceived barrier to physical activity participation (proximity to exercise facilities) by investigating the distance a population-based cohort of young people with cerebral palsy aged 13-30 years lived from community gyms.Method:We developed a web-based application using open-access software that could be used to complete a geospatial analysis by simultaneously visualising, describing, and estimating the location of young people with cerebral palsy, using deidentified data from a cerebral palsy register, in terms of distance and travel time to all available community gyms in one metropolitan city. The suitability of facilities for individuals was not investigated. Distance to the closest gym for participants was measured using the "as the crow flies" and "street network" methods. The proportion of the cohort living 5, 7, and 9 km from a community gym was calculated using the "as the crow flies" method. Distances and travel times to the closest gym for each person were calculated using the "street network" method. Data analysis used one-dimensional (median, quartiles) and two-dimensional (spatial median, bagplot) dispersion measures.Results:Of 568 young people with cerebral palsy, 97% lived within 7 km of a community gym, with a median absolute distance to their closest gym of 3.6 km (1(st) and 3(rd) quartiles 2.4, 5.1) and median travel time of 6.6 minutes (1(st) and 3(rd) quartiles 4.4, 8.8) by car. For the two-dimensional analysis, the spatial medians were 3.7 km and 6.5 minutes.Conclusions:The open-access, web-based application that was developed can be used by physiotherapists and others to study proximity of clinical and community infrastructure for other populations in other cities and regions. In this study, most young people with cerebral palsy living in one metropolitan city had reasonable access by car to a community gym.