These stories are based on my experience working with computers and people with disabilities and with the application of ergonomics to computers (since 1980). The stories are not based on specific individuals. Rather they are composites of people who experienced a particular problem or came from a particular employment background and the technology accommodations that helped these people deal with their problems. Via these case stories I hope to present some of the background as to why people sought assistance, as well as the type of technology accommodations that worked for them. By these examples I hope that people can start to develop their own solutions to their problems.
Before proceeding to the Case Stories, it is important to understand some of the background issues that lead to the resolution of these problems of ergonomics and computers. The following list is a set of general principles as they apply to ergonomics.
- The technology is not a cure. If you have sustained a soft tissue injury, such as a carpal tunnel syndrome, then that injury will not be cured by using a different keyboard or mouse. What the technology provides is a different way of working that will either eliminate or reduce the aggravating factors that may have caused the problem in the first place.
- Soft tissue injuries can linger for a long time. The best approach is to make changes in the early stages of your symptoms and not to wait until the pain is debilitating.
- If you are experiencing problems, see your physician.
- Work from the gound up. Technology considerations are usually among the last parts of the accommodation puzzle. You should start with your general body posture.
- Seating: sit so that your ankles, knees, and hips are at ~90° angles. Your arms should form an angle between 90° and 105° at the elbow, with the arms resting comfortable at your sides or on the armrests of the chair. Proper seating is crucial for avoiding postural pains. Seating also has a direct effect on the position of your forearms and hands while operating a computer keyboard or mouse. Poor seating can contribute to wrist and other arm pain and discomfort. Analyze your posture. If you are perching on the edge of your chair then the chair is probably too high. If you are slouching then there is a good chance your chair is too low.
- Desk or table heights: should allow you to sit as described in the above point. If the desk height is too high to maintain this posture then raise your chair and place your feet on a footrest. If the desk is too low consider a height-arjustable keyboard arm and raise your monitor with a monitor arm or heavy books.
- Monitor: should be positioned so that you can easily read the screen (roughly an arm's length away) without twisting or extending your neck. It should be right in front of you with your head held in a postion similar to when you read a newspaper.
- Keyboard and your mouse: should be on the same work surface. Having a mouse on a different, higher surface, such that you have to reach for it, is a sure recipe for shoulder discomfort.
- Take breaks. Human beings were not built to sit in the same position and do the same repetitive tasks for hour on end. Develop a routing by which you take regular breaks. A few minutes every hour, get up, stretch and look away from your monitor. A bathroom break also accomplishes this objective. You can also get software that reminds you it is time to take a break.
- Don't forget the mouse. While keyboards get a great deal of the ergonomic press, mice are also part of the ergonomic equation.
- Adjustable is always better. Devices that allow you to make changes to your setup while working are recommend over devices that are not adjustable, or require a lot of effort to adjust. Adjustable devices allow you to make small changes to your equipment throughout the day - another ergonomic principle to keep in mind.
- Cummulative Effect: repetitive strain issues relate to all of the activities you do during the day, not just your work. While your position at work is very important, so too is your setup at home, especially if you spend several hours a day on your home computer, whether working, gaming or surfing the Internet.
- All solutions are personal. Just because your co-worker opted for one solution does not mean it is the best solution for you. Factors such as body type, body height, and type and degree of injury will have an impact on your technology solution.
M was a paralegal, a touch-typist, capable of sustaining speeds in excess of 80wpm. M noticed that she was feeling wrist pain at increasingly frequent intervals. She suspected that she might be getting Carpal Tunnel Syndrome, but this was never formally diagnosed. She had a coworker who, after ~20 years of high-speed typing, finally sustained soft tissue injuries so bad that she could no longer pickup a piece of paper from a table. M desperately wanted to avoid that fate.
M found the most comfortable solution was an adjustable split keyboard with a trackball positioned between the two halves of the keyboard. The adjustable tenting of the keyboard allowed for a more comfortable wrist position while typing (less pronation), and the trackball eliminated the need to hold a mouse (no static grip).
|Freestyle keyboard with an L-Trac trackball positioned between the two halves of the keyboard.|
N was a receptionist in a busy reception area, with lots of phone calls and walk-in customers requiring attention. This position required a lot of simultaneous telephone and computer work (having to mouse to different fields and enter data in those fields). N was diagnosed with tennis elbow (lateral epiconylitis).
Due to the extensive interaction with walk-in customers, the use of a telephone headset (the usual accommodation for someone in a telephone reception position) was declined. Instead, we placed the telephone on a mobile stand so that the phone could be brought closer into the workspace (and pushed out of the way when not in use). The standard mouse was replaced with a contoured mouse, and the keyboard replaced with a left-handed keyboard (numeric keypad on the left) so that the mouse could be brought closer to the keyboard, which reduced the amount of reaching.
O worked in the financial services industry and spent his days monitoring stock and commodity prices. He had several monitors, and each monitor had several windows open to the various items he was monitoring. O developed shoulder pain that started as a minor inconvenience but eventually grew into a constant ache that was aggravated every time he used the mouse.
The standard mouse was replaced with a touchpad mouse, which he held in his lap and manipulated with the fingers of his right hand. Because the touchpad is a stationary mouse, it did not require shoulder movement to operate. Footswitches were also added so that mouse clicking could be done with the feet. O replaced his standard keyboard with a small footprint keyboard, so that the bulk of his keyboarding could be done one-handed (left hand only). The monitors were mounted on arms and positioned at the same height in a kind of semicircle, so that they were all the same distance away from O.
Q worked in a sawmill until an industrial accident resulted in the amputation of several fingers from his dominant hand. This traumatic injury meant he could no longer work in this industry and had to shift to a more sedentary occupation.
Because he had problems gripping the standard mouse with his dominant hand, Q changed to a trackball mouse. This he was able to operate with the digits of his right hand. For keyboarding, a new home key strategy was required in order to accommodate for the loss of the fingers. Q continued to work on a standard keyboard.
R sustained a stroke, known medically as a cerebral vascular accident. This resulted in a paralysis of his right side (hemiplegia).
T sustained a shoulder injury while working as a trucker. Sustained movements, such as holding a steering wheel, resulted in severe pain, necessitating a change in occupation.
R was provided with articulating armrests. These armrests support the forearms and take the weight of the arms off the shoulders. This accommodation was enough to alleviate the shoulder pain that R experienced while operating a mouse. The standard mouse was replaced by a vertical mouse, which helped in shoulder pain relief as the vertical mouse was held with the forearm in neutral (handshake position) rather than in pronation.
U had visual perceptual problems. When he looked at the standard "staggered" keyboard he had trouble finding the keys he needed. Consequently, his typing speed was slow and prone to errors.
It was discovered that a keyboard with an orthogonal layout (the keys are in straight columns - no staggering) improved U's typing accuracy, as well as resulting in a small improvement in overall speed.
V was a freelance writer. Her job involved a great deal of typing and everything had a deadline. She frequently worked long hours, often through the night, in order to meet those deadlines. V was a touch typist, capable of speeds greater than 80wpm. V frequently had general upper arm fatigue and aches and pains. These were generalized symptoms, not focused on any particular part of the body
V found that a contoured keyboard allowed her to maintain her fast typing, but in a much more ergonomic position - it eliminated ulnar deviation and wrist flexion and placed far less stress on her arms and shoulders. This was used with a touchpad mouse, with which she was comfortable as a result of using the touchpad on her laptop computer. A document holder was positioned between the keyboard and monitor, so that V could avoid twisting to read her source materials.