Usage Position and Virtual Keyboard Design Affect Upper-Body Kinematics, Discomfort, and Usability during Prolonged Tablet Typing

The impact of remote work using mobile information and communication technologies on physical health: a systematic review

Remote e-working with information and communication technology (ICT) has long been on the rise, with its implementation accelerated by mandatory working from home regulations during the COVID-19 pandemic. This systematic literature review summarises the influencing factors of ICT-based remote e-working (device types, duration of use, user interfaces, etc.) on the physical health (musculoskeletal system and eyes) of knowledge workers. A search in four electronic databases and a manual search in four German journals resulted in 21 articles being included in this review. A bias analysis was conducted for all articles. Unfavourable postures, inappropriate working devices and certain environmental factors may cause a range of physical complaints, even after comparably short periods of time. Mostly, these complaints are greater compared to those experienced when working on a fully equipped stationary computer. Therefore, remote e-working requires careful planning, awareness, and the willingness to embrace working situations that counteract these problems.

Use of an inflatable mat to reduce body discomfort development when performing computer work at a standing desk

This study aimed to determine the effects of inflatable mat design on body discomfort, task performance, and musculoskeletal exposures during standing computer work. Twenty-seven healthy adults completed three 2-hour standing trials on different mediums (concrete floor, foam mat, and inflatable mat) on different days in an experimental laboratory. Both mats were associated with reduced discomfort in all lower-body regions and increased typing performance compared to the concrete floor. Perceived discomfort in lower extremities (except thighs) was further alleviated while standing on the inflatable mat than on the foam mat. Use of the inflatable mat led to increased lower-body muscle activity, a flexed lower back, and a wide range of sagittal knee movements. As standing time increased, body discomfort increased, typing accuracy decreased, and there were increased variations in muscle activity and postural movements in the lower body. The inflatable mat shows potential to improve the ergonomic experience during prolonged standing. Practitioner summary: Incorporating standing postures in office-based workplaces can reduce sitting time and may mitigate the health hazards associated with sedentary behaviour. With adequate weight-shifting movements, using an inflatable mat for standing could be an effective way to lessen discomfort and accumulated musculoskeletal strain due to constrained standing, without jeopardising task productivity. Abbreviations: APDF: amplitude probability distribution function. AVR: average rectified value. CI: confidence interval. CMRR: common mode rejection ratio. COP: center of pressure. CV: coefficient of variation. EA: electrical activity. EMG: electromyography. FL: fibularis longus. GM: gluteus medius. LBP: lower back pain. LES: lumbar erector spinae. MVC: maximum voluntary contraction. PD: pain developer. rANOVA: repeated-measures analysis of variance. SOL: soleus. VAS: visual analog scale. WPM: words per minute.

Using touchscreen mobile devices-when, where and how: a one-week field study

This cross-sectional study explored the objectively measured Touchscreen Mobile Device (TSMD) use in free-living conditions. Data on TSMD use, gross body posture (lying, sitting, standing, stepping), and location of use (workplace, home, other) were collected over seven consecutive days from 54 adults (mean ± SD, 38 ± 10 years). The average duration of TSMD use was 152 ± 91 min/day, with a TSMD engagement of 51 ± 35 times/day. Participants under 30 years spent significantly more time on their TSMD, averaging 230 ± 108 min/day. By location, 54 ± 17% of use occurred at home and 24 ± 15% at work. The most common posture adopted during any TSMD use was sitting (77 ± 5 2 min/day), with participants also spending considerable time lying down in the home environment (39 ± 49 min/day). These findings provide valuable insights into how adults are using TSMDs, including the postures and locations of use. Further research is needed on the health and wellbeing implications of these usage patterns. Practitioner summary: This study explored Touchscreen Mobile Device (TSMD) use in free-living conditions among 54 adults (mean ± standard deviation, 38 ± 10 years). Participants under 30 years spent significantly more time on their devices. More than half of the time spent using TSMD occurred at home while sitting and lying down.Abbreviations: TSMD: touchscreen mobile device; SD: standard deviation; MSD: musculoskeletal disorder; HDR: higher degree by research; SEES: School of Earth and Environmental Sciences; UK: The United Kingdom; USA: United States of America; SAS: statistical analysis system; ANOVA: analysis of variance; SPSS: statistical package for the social sciences; h: hour; min/d: minutes per day; d: day; ICC: intraclass correlation; CI: confidence interval; min: minute; GPS: global positioning systemsHighlightsTouchscreen mobile device use and gross body posture were quantified objectively.The most common postures for touchscreen mobile device use were lying and sitting.Touchscreen mobile devices were used around twice as much at home than at work.Use at home, with a predominance of the lying posture, needs further investigation.

Almost a year in: Virtual offices remained an ergonomic trouble spot

BACKGROUND

Many individuals continued to work from home even after nearly 9 months since the COVID-19 pandemic started in spring of 2020.

OBJECTIVE

To conduct a follow-up survey of the faculty and staff of a large Midwest university to determine whether there had been any changes to their home work environment and health outcomes since a prior survey conducted at the start of the pandemic in spring of 2020.

METHODS

An electronic survey was sent out to all employees, staff, and administration (approximately 10,350 individuals) and was completed by 1,135 individuals.

RESULTS

It was found that not much had changed after nearly 9 months of working at home. Faculty and staff continued to primarily use laptops without an external keyboard, monitor or mouse. Few participants reported using chairs with adjustable armrests. These conditions continued to result in high levels of body discomfort (49% neck and head, 45% low back, and 62% upper back and shoulders having moderate to severe pain).

CONCLUSION

If workers are going to continue to work from home, companies will need to accommodate them with more than a laptop, and should include an external keyboard, monitor, and mouse.

Lateral epicondylosis: A literature review to link pathology and tendon function to tissue-level treatment and ergonomic interventions

BACKGROUND

Common treatments for lateral epicondylosis (LE) focus on tissue healing. Ergonomic advice is suggested broadly, but recommendations based on biomechanical motion parameters associated with functional activities are rarely made. This review analyzes the role of body functions and activities in LE and integrates the findings to suggest motion parameters applicable to education and interventions relevant to activities and life roles for patients.

PURPOSE

This study examines LE pathology, tendon and muscle biomechanics, and population exposure outlining potentially hazardous activities and integrates those to provide motion parameters for ergonomic interventions to treat or prevent LE. A disease model is discussed to align treatment approaches to the stage of LE tendinopathy.

STUDY DESIGN

Integrative review METHODS: We conducted in-depth searches using PubMed, Medline, and government websites. All levels of evidence were included, and the framework for behavioral research from the National Institutes of Health was used to synthesize ergonomic research.

RESULTS

The review broadened the diagnosis of LE from a tendon ailment to one affecting the enthesis of the capitellum. It reinforced the continuum of severity to encompass degeneration as well as regeneration. Systematic reviews confirmed the availability of evidence for tissue-based treatments, but evidence of well-defined harm reducing occupational interventions was scattered amongst evidence levels. Integration of biomechanical studies and population information gave insight into types of potentially hazardous activities and provided a theoretical basis for limiting hazardous exposures to wrist extensor tendons by reducing force, compression, and shearing during functional activities.

CONCLUSIONS

These findings may broaden the first treatment approach from a passive, watchful waiting into an active exploration and reduction of at-risk activities and motions. Including the findings into education modules may provide patients with the knowledge to lastingly reduce potentially hazardous motions during their daily activities, and researchers to define parameters of ergonomic interventions.

Influence of virtual keyboard design and usage posture on typing performance and muscle activity during tablet interaction

This study aimed to determine the effects of virtual keyboard designs and postures on task performance and muscle activity during tablet use. Eighteen healthy adults were randomly assigned to one of three postures (DESK, LAP, BED) to complete six sessions of 60-minute typing on a tablet with three virtual keyboards (STD, WIDE, SPLIT) twice in an experimental laboratory. Keystroke dynamics and muscle activity of the forearm and neck-shoulder regions were measured by electromyography. The split virtual keyboard was found to be associated with faster typing speed (SPLIT vs STD, p = .015; SPLIT vs WIDE, p < .001) and decreased muscle activity of extensor digitorum communis (SPLIT vs STD, p = .021). Lap posture was associated with faster typing speed (p = .018) and higher forearm muscle activity (p < .05). Typing performance decreased (p < .001) with elevated neck extensor muscle activity (p = .042) when the task duration prolonged. The split virtual keyboard showed potential to improve tablet ergonomics under various postures. Practitioner Summary: Tablets have become widely used for a variety of tasks and have gradually expanded into the realm of mobile productivity and education. Adequate designs of virtual keyboards for tablets show the potential for increased task performance and decreased muscle activity pertinent to typing activity and posture constraints imposed by non-traditional work positions. Abbreviations: WPM: words per minute; IKI: inter-key press interval; EMG: electromyography; EDC: extensor digitorum communis; FDS: flexor digitorum superficialis; CES: cervical erector spinae; UT: upper trapezius; EA: electrical activity; MVC: maximum voluntary contraction; APDF: amplitude probability distribution function.

Functional parameters, wrist posture deviations and comfort: A comparison between a computer mouse and a touch pen as input devices

BACKGROUND

Performing common computer tasks such as pointing, clicking, and dragging requires repetitive movements that cause musculoskeletal disorders in the wrists and hands. Given the growing use of touch screens and touch pens, further studies on the ergonomics of these devices are needed. This study aimed to compare a touch pen and an ordinary computer mouse in terms of movement time, error rate, wrist posture, and comfort of use.

METHODS

Performance parameters (movement time and error rate), wrist postures, and comfort when using a mouse and a touch pen were measured based on ISO 9241-9 standard with the help of 27 participants. For data analysis, paired t test was performed using SPSS version 22.

RESULTS

Using the touch pen resulted in better performance parameters than using the mouse (p < 0.05). Wrist extension and flexion were lower when performing the task with the computer mouse than with the touch pen (p < 0.05). When using the touch pen to perform the task, ulnar deviation and radial deviation were lower (p < 0.05). The overall comfort was higher when using the mouse than the touch pen.

CONCLUSION

Our results showed that the touch pen had better performance parameters than the ordinary mouse and also resulted in lower ulnar and radial deviations. Given the impact of habit and proficiency on users' comfort in using input devices, it is reasonable to expect users becoming more comfortable by using touch pens on the long term.

The associations of mobile touch screen device use with musculoskeletal symptoms and exposures: A systematic review

BACKGROUND

The use of mobile touch screen devices (MTSDs) has increased rapidly over the last decade, and there are concerns that their use may have negative musculoskeletal consequences; yet evidence on the association of MTSD use with musculoskeletal symptoms and exposures is currently dispersed. The aim of this study was to systematically review available literature on musculoskeletal symptoms and exposures associated with MTSD use. The synthesised information may facilitate wise use of MTSDs and may identify areas in need of further research.

METHODS

EMBASE, Medline, Scopus, PsycINFO and Proquest electronic databases were searched for articles published up to June 2016, using keywords describing MTSD, musculoskeletal symptoms (e.g. pain, discomfort) and musculoskeletal exposures (e.g. posture, muscle activity). Two reviewers independently screened the articles, extracted relevant data and assessed methodological quality of included studies. Due to heterogeneity in the studies, a meta-analysis was not possible and a structured narrative synthesis of the findings was undertaken.

RESULTS

A total of 9,908 articles were screened for eligibility with 45 articles finally included for review. Included articles were of cross-sectional, case-control or experimental laboratory study designs. No longitudinal studies were identified. Findings were presented and discussed in terms of the amount, features, tasks and positions of MTSD use and its association with musculoskeletal symptoms and musculoskeletal exposures.

CONCLUSIONS

There is limited evidence that MTSD use, and various aspects of its use (i.e. amount of usage, features, tasks and positions) are associated with musculoskeletal symptoms and exposures. This is due to mainly low quality experimental and case-control laboratory studies, with few cross-sectional and no longitudinal studies. Further research is warranted in order to develop guidelines for wise use of MTSDs.

Towards Usable E-Health. A Systematic Review of Usability Questionnaires

BACKGROUND

The use of e-health can lead to several positive outcomes. However, the potential for e-health to improve healthcare is partially dependent on its ease of use. In order to determine the usability for any technology, rigorously developed and appropriate measures must be chosen.

OBJECTIVES

To identify psychometrically tested questionnaires that measure usability of e-health tools, and to appraise their generalizability, attributes coverage, and quality.

METHODS

We conducted a systematic review of studies that measured usability of e-health tools using four databases (Scopus, PubMed, CINAHL, and HAPI). Non-primary research, studies that did not report measures, studies with children or people with cognitive limitations, and studies about assistive devices or medical equipment were systematically excluded. Two authors independently extracted information including: questionnaire name, number of questions, scoring method, item generation, and psychometrics using a data extraction tool with pre-established categories and a quality appraisal scoring table.

RESULTS

Using a broad search strategy, 5,558 potentially relevant papers were identified. After removing duplicates and applying exclusion criteria, 35 articles remained that used 15 unique questionnaires. From the 15 questionnaires, only 5 were general enough to be used across studies. Usability attributes covered by the questionnaires were: learnability (15), efficiency (12), and satisfaction (11). Memorability (1) was the least covered attribute. Quality appraisal showed that face/content (14) and construct (7) validity were the most frequent types of validity assessed. All questionnaires reported reliability measurement. Some questionnaires scored low in the quality appraisal for the following reasons: limited validity testing (7), small sample size (3), no reporting of user centeredness (9) or feasibility estimates of time, effort, and expense (7).

CONCLUSIONS

Existing questionnaires provide a foundation for research on e-health usability. However, future research is needed to broaden the coverage of the usability attributes and psychometric properties of the available questionnaires.