Differences between work methods and gender in computer mouse use

Wrist motion is distinct between touch screen and manual or digital devices

BACKGROUND

Restricted motion during touch screen device use may contribute to wrist overuse injuries. Wrist radioulnar deviation and extension while using touch screen devices and digital or manual counterparts in male and female medical professional dominant and non-dominant hands were quantified to test the hypothesis that mobile touch screen device use reduces wrist motion.

METHODS

An active motion detection system was used to record wrist motion of 12 participants while: tablet swiping and turning book pages; raising a cell and traditional phone to the ear; texting and typing; and entering numbers on a cell phone and manual calculator. Medial and lateral wrist surface range of motion (ROM) and minimum and maximum wrist radial-ulnar deviation and flexion-extension were quantified.

RESULTS

Device, sex and handedness effects were determined (P<0.05). Maximum medial radial deviation and ROM were greater using a cell versus traditional phone. Maximum medial radial deviation was higher in the nondominant wrist during backward tablet swiping and while backward page turning versus tablet swiping. Maximum and minimum medial extension angles and ROM were greater while typing versus texting. Female nondominant hand maximum lateral extension and ROM were greater for typing versus texting and maximum medial extension and lateral extension ROM greater during manual versus cell phone calculator use with handedness combined. Maximum lateral extension and ROM were greater in females versus males using manual calculators.

CONCLUSIONS

Sex and handedness should instruct touch screen, digital and manual device design and use for optimal performance and injury prevention.

Impact of task variation and microbreaks on muscle fatigue at seated and standing postures

BACKGROUND

Prolonged and sustained work posture among computer users is one of the main factors that contributes to musculoskeletal discomfort. Rest-break interventions such as task variation and microbreaks may help prevent muscle fatigue and work-related musculoskeletal disorder.

OBJECTIVE

We aimed to investigate the effects of task variation and microbreaks at seated and standing workstations on forearm muscle activity, namely extensor digitorum communis, extensor carpi ulnaris, flexor digitorum superficialis, and flexor carpi ulnaris; mouse operation force (vertical compression force); mouse operation parameters; and perceived body discomfort during mouse operation.

METHODS

Twelve healthy right-handed young adults were recruited (male: n = 7, 21.6±1.4 years; female: n = 5, 21.4±1.7 years). Participants performed three blocks of computer tasks (computer mouse operation and typing) in both seated and standing postures with each block lasting for 30 min. Surface electromyography (EMG) of the forearm muscles and operation force were monitored during computer mouse operation. Body discomfort rating was recorded at the end of each block.

RESULTS

With simulated task variation and microbreaks, work posture and work time showed no significant difference with EMG amplitude and mouse operation force.

CONCLUSION

Task variation and microbreaks could be of benefit to computer users by reducing muscle fatigue during long hours of computer work at both seated and standing workstations.

The Effects of Standing Working Posture on Operation Force and Upper Limb Muscle Activation When Using Different Pointing Devices

This study investigated how sitting and standing working postures affected operation force, upper limb muscle activation, and task performance using different pointing devices. Fifteen male participants completed cursor aiming and dragging tasks using a conventional mouse, a vertical mouse, and a trackball at sitting and standing workstations. A custom-made force plate was used to measure operation forces applied to the pointing devices. Surface electromyography (EMG) was used to capture the activation of the biceps brachii, triceps brachii, deltoid, and trapezius. Task performance was measured by task success rates, and subjective ratings were obtained for the force required for operation, smoothness of operation, accuracy, and local fatigue in the upper limb. We quantified the following significant outcomes: (1) greater operation forces were found when standing; (2) standing reduced EMG amplitudes of the triceps and trapezius muscles for all tasks; (3) during the aiming task, the vertical mouse had greater operation forces; (4) during the dragging task, both the vertical mouse and trackball had greater operation forces; and (5) task success rates differed for pointing devices only when sitting. This study revealed the distinct biomechanical properties of standing working posture and suggested limited beneficial effects of alternative pointing devices in terms of task performance and subjective ratings.

Sex-specific muscle activation and oxygenation kinetics during a repetitive forward pointing task

We compared the minute-by-minute muscle activity and oxygenation responses to a repetitive arm motion-induced fatiguing task between the sexes in order to address the literature gap on these time-dependent fatigue responses. Twenty-six (13 females) healthy adults performed a repetitive pointing task (RPT) with the arm moving forward/backward at shoulder height until reaching 8/10 (Borg CR10) for neck/shoulder perceived exertion (RPE). Neck/shoulder RPE, oxygenation and electromyography were recorded every minute and compared between first and second half of the task and between the sexes. Greater changes in oxygen supply and activation amplitude occurred during the second half of the task. Despite similar time to fatigue-terminal (p > 0.05), females showed greater anterior deltoid activation amplitude at all time points than males, and only the males showed increases in anterior and posterior deltoid activation amplitudes. In females, middle (ρ = -0.34, p = 0.04) and posterior (ρ = -0.44, p = 0.01) deltoid amplitudes were negatively correlated with perceived exertion during the first half of the task. Results suggest that reduced modulation of anterior deltoid activation amplitude in females may reflect a sub-optimal fatigue-mitigation mechanism compared with males and may help explain their greater susceptibility to neck/shoulder musculoskeletal disorders. Novelty: Despite similar fatigability and trapezius oxygenation, females showed greater deltoid activation throughout the task. Deltoid activation increased in males but not in females. The results support the important role of the deltoid in sex-specific neck/shoulder injury mechanisms.

Changes in muscle activation, oxygenation, and morphology following a fatiguing repetitive forward reaching task in young adult males and females

We sought to evaluate sex-specific 1) muscle activation patterns, hemodynamics, and swelling responses to short-cycle repetitive fatigue; 2) relationships between muscular responses and perceived fatigability. Asymptomatic participants (N = 26, 13 females) completed a repetitive pointing task until 8/10 on the Borg CR10 scale. Upper trapezius (UT), supraspinatus (SUPRA), and biceps brachii (BIC) muscle activation, activation variability (CV), median power frequency (MdPF) and thickness, and UT oxygenation were recorded. Males had higher BIC CV, UT and SUPRA MdPF, and UT and BIC thickness. Longer time to fatigue-terminal was correlated to greater SUPRA activation increase (ρ = 0.624) and BIC MdPF decrease (ρ = -0.674) in males, while in females it was correlated to greater (ρ = -0.657) and lower (ρ = 0.683) decrease of SUPRA and BIC CV, respectively. Male's greater increase in SUPRA thickness correlated to greater increase in UT thickness and tissue oxygenation index, and to lower increase of UT deoxyhemoglobin. Females' greater decrease of SUPRA MdPF correlated to greater decrease of UT MdPF, while greater UT activation increase was related to lower UT thickness increase. Results suggest that despite comparable time to fatigue-terminal, males have greater force-generating capacity and neuromuscular reliance on recruitment and excitation rates, while females have greater reliance on activation variability. Further, there are relationships between hemodynamic and swelling patterns in males, while there are relationships between activation and swelling patterns in females. Although there were no differences in experimental task-induced changes, there are sex-specific relationships between muscular patterns and perceived fatigability, which may help explain sex-specific mechanisms of musculoskeletal disorders.

Does sEMG normalization change results on sex differences in the activation of the shoulder girdle muscles during a simulated work task?

The aim was to investigate if the method of normalizing surface electromyography (sEMG) can change results on sex differences in the muscular activation of the shoulder girdle muscles during a simulated work task. sEMG was recorded in 36 asymptomatic participants (17 females, 19 males) from four parts of trapezius and from serratus anterior muscles during a simulated work task. Four normalization methods, one involving maximal voluntary contractions (MVCs) and three involving submaximal voluntary contractions were applied. Sex differences in absolute and normalized amplitude of sEMG were analyzed. The normalization method had a significant influence on the observed sex differences. Females only showed higher sEMG amplitude than males when the sEMGs were normalized to MVC and to a submaximal contraction based on 20% of MVC for the upper trapezius (acromial fibers). Researchers and practitioners should be aware of the impact of the sEMG normalization method in sex differences investigation.

A comparison of hazard perception and hazard prediction tests across China, Spain and the UK

Hazard perception (HP) is the ability to spot on-road hazards in time to avoid a collision. This skill is traditionally measured by recording response times to hazards in video clips of driving, with safer, experienced drivers often out-performing inexperienced drivers. This study assessed whether HP test performance is culturally specific by comparing Chinese, Spanish and UK drivers who watched clips filmed in all three countries. Two test-variants were created: a traditional HP test (requiring timed hazard responses), and a hazard prediction test, where the film is occluded at hazard-onset and participants predict what happens next. More than 300 participants, across the 3 countries, were divided into experienced and inexperienced-driver groups. The traditional HP test did not discriminate between experienced and inexperienced drivers, though participant nationality influenced the results with UK drivers reporting more hazards than Chinese drivers. The hazard prediction test, however, found experienced drivers to out-perform inexperienced drivers. No differences were found for nationality, with all nationalities being equally skilled at predicting hazards. The results suggest that drivers' criterion level for responding to hazards is culturally sensitive, though their ability to predict hazards is not. We argue that the more robust, culturally-agnostic, hazard prediction test appears better suited for global export.

Workstation configuration and container type influence upper limb posture in grocery bagging

INTRODUCTION

Repetitive movements and awkward postures are two persistent injury risk factors for grocery store cashiers. Due to the recent rise in popularity of environmentally-friendly grocery bagging options, current recommendations for cashiers are likely outdated. Correspondingly, the objective of this study was to examine the effects of cashier-specific work demands, workstation configuration, and container type on upper limb postures during typical job activities.

METHODS

Fifteen experienced cashiers bagged groceries at varying combinations of workstation height (low, medium, high) and container type (reusable bins, reusable bags, plastic bags). Upper limb movement was quantified with motion capture and amplitude probability distribution functions of humeral elevation and humeral axial internal rotation were used to assess the static (10th percentile), median (50^th percentile), and peak (90^th percentile) postural demands, which were then interpreted in the context of existing postural guidelines.

RESULTS

High workstation height and reusable bags increased right arm elevation at peak posture by 15.7° compared to the low workstation height and reusable bin combination. However, reusable bins increased internal rotation demands of the right arm by 4.3° compared to other container types. Left arm elevation and internal rotation were consistently lower than right arm angles.

CONCLUSION

Cashiers are encouraged to adjust the workstation to decrease the arm elevation and internal rotation required by higher workstation heights and tall containers, and to use both arms for scanning and packing, when possible, to reduce undesirable arm postures.

Mechanical stress

This chapter discusses mechanical stressors that are believed to be associated with work-related musculoskeletal disorders. It starts with an introduction to work-related musculoskeletal disorders (particularly those with high incidences in workplaces, such as disorders of low back, neck/shoulder, hand/wrist, elbow, and knee) in high-risk industries, and those mechanical stressors (such as high forces, awkward postures, high repetitions, excessive contact stress, and harmful human vibrations) in workplaces that are responsible for these disorders. Quantification methods of these mechanical stressors are then discussed. Although various quantification methods such as self-report, observational technique, and direct measurement are discussed, details are focused on many of those well-published observational techniques used by practitioners to assess risk levels of these mechanical stressors in jobs. These methods can quantify job mechanical stressors and provide risk level indications that can be used by practitioners to facilitate their decision making. These methods can also be used to evaluate the improvements of ergonomics interventions by comparing the risk levels quantitatively before and after the interventions.

Ergonomic Design of a Computer Mouse for Clients With Wrist Splints

OBJECTIVE. We explored effects of cutaneous feedback and hump position on efficiency and comfort in mouse use with a splint. We also analyzed the relationship between anthropometric measurements (width of hand and length of hand, palm, and index) and the task performance.

METHOD. Thirty participants performed a computer task with two forms of mice (front hump and rear hump) and two kinds of wrist splints (dorsal and volar). Movement time and satisfaction scores were recorded.

RESULTS. No interaction effect (Hump Position × Splint Type) was found on movement time. Movement time was shorter for rear-hump mouse users than for front-hump mouse users. Movement time was also shorter for wearers of dorsal wrist splints than for wearers of volar wrist splints. Limited differences existed in the satisfaction scores. Participants with a longer index finger had shorter movement time.

CONCLUSION. Both dorsal wrist splints and rear-hump mice are recommended. Length of index finger positively correlated with task performance.

Computer work and self-reported variables on anthropometrics, computer usage, work ability, productivity, pain, and physical activity

Background

Computer users often report musculoskeletal complaints and pain in the upper extremities and the neck-shoulder region. However, recent epidemiological studies do not report a relationship between the extent of computer use and work-related musculoskeletal disorders (WMSD).

The aim of this study was to conduct an explorative analysis on short and long-term pain complaints and work-related variables in a cohort of Danish computer users.

Methods

A structured web-based questionnaire including questions related to musculoskeletal pain, anthropometrics, work-related variables, work ability, productivity, health-related parameters, lifestyle variables as well as physical activity during leisure time was designed. Six hundred and ninety office workers completed the questionnaire responding to an announcement posted in a union magazine. The questionnaire outcomes, i.e., pain intensity, duration and locations as well as anthropometrics, work-related variables, work ability, productivity, and level of physical activity, were stratified by gender and correlations were obtained.

Results

Women reported higher pain intensity, longer pain duration as well as more locations with pain than men (P < 0.05). In parallel, women scored poorer work ability and ability to fulfil the requirements on productivity than men (P < 0.05). Strong positive correlations were found between pain intensity and pain duration for the forearm, elbow, neck and shoulder (P < 0.001). Moderate negative correlations were seen between pain intensity and work ability/productivity (P < 0.001).

Conclusions

The present results provide new key information on pain characteristics in office workers. The differences in pain characteristics, i.e., higher intensity, longer duration and more pain locations as well as poorer work ability reported by women workers relate to their higher risk of contracting WMSD. Overall, this investigation confirmed the complex interplay between anthropometrics, work ability, productivity, and pain perception among computer users.

The influence of mental load on muscle tension

We examined the differences in muscle tension and in physiological measures depending on the type of mental task. Fifteen participants performed tests for sustained attention, vigilance and maintaining posture only. We analysed electromyogram (EMG) measures of extensor digitorum (ED), flexor carpi ulnaris (FU), deltoideus (DE) and trapezius (TR), and heart rate (HR) and respiratory frequency (RF). Measures indicated higher values for mental tasks than for maintained posture only with significant differences in all measures. The following relationships were also significant: between DE and physiological measures (HR and RF), between ED and the amplitude of EMG of the other three muscles, between FU and TR and between HR and RF. The results of this study showed that the relationship between mental demands and muscle tension was mostly reflected by tension in the arm and shoulder girdle muscles and, to a lesser degree, in forearm muscles.

PRACTITIONER SUMMARY

We focused on physiological and muscle tension measures differentiating work according to the level of mental demands. Differences in sustained attention, vigilance and maintaining posture only proved that mental demands were mostly reflected by tension in arm and shoulder girdle muscles and, to a lesser degree, in forearm muscles.

Comparison of posture and muscle control pattern between male and female computer users with musculoskeletal symptoms

The primary purpose of this study was to compare the posture and muscle control patterns between male and female computer users with musculoskeletal symptoms. Forty computer users were recruited. Each subject performed a preferred speed typing, a fast speed typing, and a repetitive mouse task. The independent variables were gender, typing speed, and time. There were significant differences between genders for head and neck flexion angles when they were performing the preferred speed typing task. Significant differences between genders were also found for upper extremity angles when they were performing the repetitive mouse task. Male computer users had a smaller root mean square of the right extensor digitorium than females. In general, postural differences were significant between genders, even when the subjects' table and chair were adjusted to meet their anthropometry. Our results suggest that modifications of the computer working environment may be different between genders.

Developing a framework for predicting upper extremity muscle activities, postures, velocities, and accelerations during computer use: the effect of keyboard use, mouse use, and individual factors on physical exposures

Prediction models were developed based on keyboard and mouse use in combination with individual factors that could be used to predict median upper extremity muscle activities, postures, velocities, and accelerations experienced during computer use. In the laboratory, 25 participants performed five simulated computer trials with different amounts of keyboard and mouse use ranging from a highly keyboard-intensive trial to a highly mouse-intensive trial. During each trial, muscle activity and postures of the shoulder and wrist and velocities and accelerations of the wrists, along with percentage keyboard and mouse use, were measured. Four individual factors (hand length, shoulder width, age, and gender) were also measured on the day of data collection. Percentage keyboard and mouse use explained a large amount of the variability in wrist velocities and accelerations. Although hand length, shoulder width, and age were each significant predictors of at least one median muscle activity, posture, velocity, or acceleration exposure, these individual factors explained very little variability in addition to percentage keyboard and mouse use in any of the physical exposures investigated. The amounts of variability explained for models predicting median wrist velocities and accelerations ranged from 75 to 84% but were much lower for median muscle activities and postures (0-50%). RMS errors ranged between 8 to 13% of the range observed. While the predictions for wrist velocities and accelerations may be able to be used to improve exposure assessment for future epidemiologic studies, more research is needed to identify other factors that may improve the predictions for muscle activities and postures.

Effects of prismatic glasses including optometric correction on head and neck kinematics, perceived exertion and comfort during dental work in the oral cavity--a randomised controlled intervention

AIM

To quantify the effects of using prismatic glasses including optometric correction, on head and neck kinematics, perceived exertion and comfort, during work in the oral cavity.

METHODS

The study population consisted of forty-five participants. After a basic ergonomic education, baseline measurements of head and neck kinematics were made using inclinometers. Perceived exertion and comfort were rated by the participants. An intervention group (n = 25), selected at random from the participants, received prismatic glasses and optometric correction when needed and were compared with a control group (n = 20). Follow up assessments were made after the intervention.

RESULTS

At follow up there was a reduction in both the intervention group (8.7°) and in the control group (3.6°) regarding head flexion. Neck flexion was reduced by 8.2° in the intervention group and 3.3° in the control group. The difference between the intervention and the control groups, i.e. the effect of the intervention, was statistically significant for both head (5.1°; p = 0.009) and neck (4.9°; p = 0.045) flexion. No effect of the intervention was seen regarding perceived exertion and comfort.

CONCLUSION

The reduction in head and neck flexion achieved by the prismatic glasses is likely to reduce the risk of neck pain during dental work. The effect of the prismatic lenses could not be separated from the effect of the optometric correction. The possible effect of the ergonomic education was not evaluated.

Are there health effects of harassment in the workplace? A gender-sensitive study of the relationships between work and neck pain

The aim of this study was to identify workplace physical and psychosocial risk factors for neck pain among male and female workers and, in particular, to study the relationship between neck pain and intimidation and sexual harassment in the workplace in a representative sample of the Quebec working population. The study sample included 5405 men and 3987 women. In multiple logistic regression analyses, when taking into account individual and other workplace factors, neck pain was significantly associated with intimidation at work among both male (odds ratio (OR) 1.4 (1.01-1.8)) and female workers (OR 1.3 (1.01-1.8)). Among female workers, neck pain was alsosignificantly associated with unwanted sexual attention (OR 1.6 (1.1-2.4)). If confirmed in prospective studies, these results suggest that interventions to prevent harassment in the workplace may help reduce musculoskeletal disorders in the workplace and that workplace programmes to reduce harassment in the workplace should include prevention of sexual harassment.

PRACTITIONER SUMMARY

While taking into account relevant personal factors and previously identified workplace physical and psychosocial risk factors, this gender-based study identifies new work exposures associated with neck pain that have not previously been studied, including unwanted sexual attention, intimidation and difficult or tense situations with the public.

Technique, muscle activity and kinematic differences in young adults texting on mobile phones

The aim of this study was to investigate whether there are differences in technique between young adults with and without musculoskeletal symptoms when using a mobile phone for texting and whether there are differences in muscle activity and kinematics between different texting techniques. A total of 56 young adults performed a standardised texting task on a mobile phone. Their texting techniques were registered using an observation protocol. The muscular activity in six muscles in the right forearm/hand and both shoulders were registered by surface electromyography and the thumb abduction/adduction and flexion/extension were registered using a biaxial electrogoniometer. Differences in texting techniques were found between the symptomatic and the asymptomatic group, with a higher proportion of sitting with back support and forearm support and with a neutral head position in the asymptomatic group. Differences in muscle activity and kinematics were also found between different texting techniques. The differences in texting technique between symptomatic and asymptomatic subjects cannot be explained by them having symptoms but may be a possible contribution to their symptoms. STATEMENT OF RELEVANCE: There has been a dramatically increased use of mobile phones for texting especially among young people during the last years. A better understanding of the physical exposure associated with the intensive use is important in order to prevent the development of musculoskeletal disorders and decreased work ability related to this use.

Thumb joint movement and muscular activity during mobile phone texting - A methodological study

PURPOSE

The extended intensive use of mobile phones and other devices for Information and Communication Technology (ICT) could expose the thumbs and fingers to operational stresses beyond their intended function which may generate pain and musculoskeletal disorders in the thumbs and the associated joints. Studies characterizing biomechanical exposures associated with mobile phone use are limited to date and the use of electrogoniometry and EMG was assessed for characterizing thumb-based activities.

SCOPE

The purpose was to investigate whether there were associations between thumb-based exposures registered with relatively easy-to-use electrogoniometric methods and more complicated EMG methods. Our hypothesis was that some outcome measures from the simpler electrogoniometric methods are related/correlated to and may be used as surrogate measure for the more complicated EMG methods.

CONCLUSIONS

Due to low associations and the complementary nature of exposures collected with electrogoniometry and EMG, the results indicated both measures are necessary for characterizing thumb exposure during mobile phone text messaging. Only in a few, selected abduction/adduction activities, could electrogoniometry be used in lieu of EMG for assessing thumb exposures.

Evidence-based guidelines for the wise use of computers by children: physical development guidelines

Computer use by children is common and there is concern over the potential impact of this exposure on child physical development. Recently principles for child-specific evidence-based guidelines for wise use of computers have been published and these included one concerning the facilitation of appropriate physical development. This paper reviews the evidence and presents detailed guidelines for this principle. The guidelines include encouraging a mix of sedentary and whole body movement tasks, encouraging reasonable postures during computing tasks through workstation, chair, desk, display and input device selection and adjustment and special issues regarding notebook computer use and carriage, computing skills and responding to discomfort. The evidence limitations highlight opportunities for future research. The guidelines themselves can inform parents and teachers, equipment designers and suppliers and form the basis of content for teaching children the wise use of computers. STATEMENT OF RELEVANCE: Many children use computers and computer-use habits formed in childhood may track into adulthood. Therefore child-computer interaction needs to be carefully managed. These guidelines inform those responsible for children to assist in the wise use of computers.

Thumb postures and physical loads during mobile phone use - a comparison of young adults with and without musculoskeletal symptoms

The aim of this study was to evaluate thumb postures, thumb movements and muscle activity when using mobile phones for SMS messaging and to determine whether there were differences in these exposures (a) across various mobile phone tasks, (b) between gender and (c) between subjects with and without musculoskeletal symptoms in shoulders and upper extremities. Fifty-six young adults (15 healthy and 41 with musculoskeletal symptoms) performed a series of distinct tasks on a mobile phone. Muscular load in four forearm/hand muscles in the right arm and the right and left trapezius muscles were measured using electromyography (EMG). Thumb movements were registered using an electrogoniometer. The results showed that postures (sitting or standing) and the type of mobile phone task (holding the phone versus texting) affected muscle activity and thumb positions. Females compared to males had higher muscle activity in the extensor digitorum and the abductor pollicis longus when entering SMS messages and tended to have greater thumb abduction, higher thumb movement velocities and fewer pauses in the thumb movements. Subjects with symptoms had lower muscle activity levels in the abductor pollicis longus and tended to have higher thumb movement velocities and fewer pauses in the thumb movements compared to those without symptoms.

Muscular activity and thermal responses in men and women during repetitive work in cold environments

Thermal responses and muscular activity in repetitive work were studied in eight women and eight men at 19 degrees C (thermoneutral) and at 4 degrees C (cold). Furthermore, effect of a heating vest was studied at 4 degrees C. Women had lower (p < 0.05) mean skin temperature compared with men at each thermal condition. Muscular activity (microV) was generally higher in women compared with men, being significantly higher in m. deltoideus (p < 0.05). Women had lower (p < 0.01) maximal isometric strength compared with men, which may have influenced the observed higher muscular activity during work in women. However, compared with thermoneutral, working in cold increased (p < 0.05) muscular activity in the forearm and upper arm extensors only in men. The vest did not significantly counteract the increase in muscular activity. In conclusion, sex differences should be considered when evaluating cold protection and work load reduction in repetitive work in cold environments. Present results indicate that in identical work, sex affects thermal responses and muscular activity during repetitive work in conditions comparable with cooled departments in the food-processing industry. Sex differences should be considered when evaluating cold protection and preventive measures for work load reduction.

Physical exposure differences between children and adults when using standard and small computer input devices

By the age of five years, 75% of the children in the USA are using computers and at this age they are only one-half to two-thirds the size of and about one-fifth as strong as their adult counterparts. Fourteen children between five and eight years of age and their same-gender biological parents (giving a total of 28 subjects) were evaluated using both a standard and a smaller, child-proportional input device during standardised mouse and keyboard tasks. Typing and computer mouse performance were measured with tracking software, wrist posture was measured with an electrogoniometer and electromyography was used to measure finger flexor and extensor muscle activity in the right arm. With the small mouse, both children and adults performed the mouse task significantly faster and made significantly fewer errors. When using the standard-sized mouse and keyboard, children worked with significantly greater ulnar deviation and significantly less extension than their adult counterparts. When children used the smaller mouse, finger flexor muscle activity, finger extensor muscle activity and ulnar deviation significantly decreased, with little change in wrist extension compared to the standard mouse. No significant differences were observed between the standard and small keyboards for children or their parents. Compared to their adult counterparts, children had to apply twice the relative force, as a percentage of their maximum capacity, to activate the buttons and keys on the input devices. These measured differences may have application in the design of computer input devices for children.

The effect of a feedback signal in a computer mouse on hovering behaviour, productivity, comfort and usability in a field study

The aim of this study was to determine the effect of a tactile feedback signal on hovering behaviour, productivity, usability and comfort after 1 week of using an experimental mouse. In a randomized controlled trial, a regular computer mouse was compared to a new developed mouse with a tactile, vibrating feedback signal to prevent unnecessary hovering above the computer mouse. According to this study, participants do decrease their hovering behaviour when using a mouse with tactile feedback. Furthermore, the mouse with tactile feedback did not influence productivity. Usability was rated somewhat mixed. The use of a mouse with a tactile vibrating feedback signal seems promising for preventing neck, shoulder and arm complaints. Further research is needed to study long-term effects on (prevention of) neck, shoulder and arm complaints and development of learning effects.

Two posture analysis approaches and their application in a modified rapid upper limb assessment evaluation

This paper presents two posture risk quantification methods: first, an event-based method where the most common and the worst postures are estimated in a task; second, a time-based method where posture distributions are calculated from random samples of observed postures in the task. A 'click-on-screen' posture data entry method was developed for the time-based posture analysis method to make the observation process easier and to reduce possible posture categorization bias. Both methods were used to quantify various work posture parameters among a study cohort of 733 subjects from a prospective epidemiological study of upper extremity musculoskeletal disorders. Composite posture indices using a modified Rapid Upper Limb Assessment (RULA) method were also computed using data obtained by the two posture analysis methods. Results showed that both methods were able to distinguish jobs with large differences in certain posture measures. However, they did not produce the same results and could not be used interchangeably. Risk evaluation criteria should be developed, either for specific posture parameters or as a composite index, with a well-defined postural analysis method, so that users can follow exact procedures and obtain comparable results. The event-based method is easy to use and may suit practitioners better, while the time-based method adds more information to the measurement and may suit users who want more detailed information about posture exposure.

Daily computer usage correlated with undergraduate students' musculoskeletal symptoms

BACKGROUND

A pilot prospective study was performed to examine the relationships between daily computer usage time and musculoskeletal symptoms on undergraduate students.

METHODS

For three separate 1-week study periods distributed over a semester, 27 students reported body part-specific musculoskeletal symptoms three to five times daily. Daily computer usage time for the 24-hr period preceding each symptom report was calculated from computer input device activities measured directly by software loaded on each participant's primary computer. General Estimating Equation models tested the relationships between daily computer usage and symptom reporting.

RESULTS

Daily computer usage longer than 3 hr was significantly associated with an odds ratio 1.50 (1.01-2.25) of reporting symptoms. Odds of reporting symptoms also increased with quartiles of daily exposure.

CONCLUSIONS

These data suggest a potential dose-response relationship between daily computer usage time and musculoskeletal symptoms.

Characterization of a laboratory model of computer mouse use - applications for studying risk factors for musculoskeletal disorders

In the present study, we assessed the wrist kinetics (range of motion, mean position, velocity and mean power frequency in radial/ulnar deviation, flexion/extension, and pronation/supination) associated with performing a mouse-operated computerized task involving painting rectangles on a computer screen. Furthermore, we evaluated the effects of the painting task on subjective perception of fatigue and wrist position sense. The results showed that the painting task required constrained wrist movements, and repetitive movements of about the same magnitude as those performed in mouse-operated design tasks. In addition, the painting task induced a perception of muscle fatigue in the upper extremity (Borg CR-scale: 3.5, p<0.001) and caused a reduction in the position sense accuracy of the wrist (error before: 4.6 degrees , error after: 5.6 degrees , p<0.05). This standardized painting task appears suitable for studying relevant risk factors, and therefore it offers a potential for investigating the pathophysiological mechanisms behind musculoskeletal disorders related to computer mouse use.

Musculoskeletal disorders among female and male air traffic controllers performing identical and demanding computer work

Operators with identical, demanding computer work (90 female and 97 male air traffic controllers) were found to have high prevalences of disorders (assessed by questionnaire and physical examination) in neck, shoulders and upper back. In spite of the identical work, the women displayed higher prevalences than the men (e.g. neck diagnoses 21% vs. 4%). Disorders in elbows, wrists and hands were less common, with similar rates in both genders. Generally, the psychosocial work environment (assessed by questionnaire) was found to be good, but with large inter-individual variation. Women experienced lower decision latitude than men, particularly regarding influence and freedom at work, but perceived higher social support. Physically, the work was characterized by relatively low angular velocities of upper arms (measured by inclinometry) and wrists (right: < 1 degrees/s during 19% of time, measuring by goniometry), dynamic muscular activities and high time fractions of rest in the trapezius and forearm extensor muscles (measuring by electromyography). There were only minor differences between the genders.

Different computer tasks affect the exposure of the upper extremity to biomechanical risk factors

In order to determine differences in biomechanical risk factors across computer tasks, a repeated measures laboratory experiment was completed with 30 touch-typing adults (15 females and 15 males). The participants completed five different computer tasks: typing text, completing an html-based form with text fields, editing text within a document, sorting and resizing objects in a graphics task and browsing and navigating a series of intranet web pages. Electrogoniometers and inclinometers measured wrist and upper arm postures, surface electromyography measured muscle activity of four forearm muscles and three shoulder muscles and a force platform under the keyboard and force-sensing computer mouse measured applied forces. Keyboard-intensive tasks were associated with less neutral wrist postures, larger wrist velocities and accelerations and larger dynamic forearm muscle activity. Mouse-intensive tasks (graphics and intranet web page browsing) were associated with less neutral shoulder postures and less variability in forearm muscle activity. Tasks containing a mixture of mouse and keyboard use (form completion and text editing) were associated with higher shoulder muscle activity, larger range of motion and larger velocities and accelerations of the upper arm. Comparing different types of computer work demonstrates that mouse use is prevalent in most computer tasks and is associated with more constrained and non-neutral postures of the wrist and shoulder compared to keyboarding.

Neuromuscular assessment in elderly workers with and without work related shoulder/neck trouble: the NEW-study design and physiological findings

Musculoskeletal disorders in the neck and shoulder area are a major occupational concern in the European countries especially among elderly females. The aim was to assess these disorders based on quantitative EMG indicators and functional tests. 252 female computer users (45-68 years) were recruited from four European countries in two contrast groups: (1) 88 neck/shoulder (NS) cases reporting trouble in the neck and/or shoulder region for more than 30 days during the last year, and (2) 164 NS-controls reporting such trouble for no more than 7 days. Questionnaires, functional/clinical tests, and physiological recordings were performed in workplace related field studies. The results showed no differences in anthropometrics but NS-cases reported more strained head positions and more eye problems than controls. The psychosocial working factors were similar, although, NS-controls had slightly better scores on working conditions, general health, and vitality compared to cases. The NS-cases had lower maximal voluntary contraction (MVC) during shoulder elevation (mean (SD) 310 (122) N) compared to the controls (364 (122) N). During 30% MVC electromyography (EMGrms) in the trapezius muscle was lower in NS-cases (194 (105) muV) than in controls (256 (169) muV), while no differences were found regarding endurance time. Estimated conduction velocity was not different between NS-cases and -controls. Four functional computer tests were performed equally well by NS-cases and -controls, and the corresponding EMG variables also did not differ. A major finding in this large-scale epidemiological study is the significantly lower MVC in NS-cases compared with NS-controls together with lower EMGrms value at 30% MVC, while computer tasks were performed at similar relative muscle activation. The study was unable to reveal quantitative EMG indicators and functional tests that could objectively assess disorders in NS-cases.

The locus of adaptation to altered gain in aimed movements

Altered gain settings cause a mismatch between the actual movement amplitude across the surface and the distance covered on a real time visual display. The present study pursued three objectives of how adaptation to altered gain affects aimed motor behavior. First, we replicated findings of an earlier study reporting a negative linear relation between gain and both target acquisition time and end-point variability. This means that our data do not agree with the classic U-shaped relation between gain and acquisition time. Second, our results proved to be robust when we manipulated movement difficulty by varying target distance. And third, dividing a movement into four successive sections on the basis of key kinematic events revealed the locus of the adaptation to altered gain within movement execution. Time differences between gain conditions proved to start at a very early part of the movement, but appeared to be absent in the final movement section. In contrast, differences between gain conditions regarding the use of online feedback were also present in the last part of the movement during which the final target approach takes place.

Physical exposure of sign language interpreters: baseline measures and reliability analysis

Measurement of physical exposure to musculoskeletal disorder risk factors must generally be performed directly in the field to assess the effectiveness of ergonomic interventions. To perform such an evaluation, the reliability of physical exposure measures under similar field conditions must be known. The objectives of this study were to estimate the reliability of physical exposure measures performed in the field and to establish the baseline values of physical exposure in sign language interpreters (SLI) before the implementation of an intervention. The electromyography (EMG) of the trapezius muscles as well as the wrist motions of the dominant arm were measured using goniometry on nine SLI on four different days. Several exposure parameters, proposed in the literature, were computed and the generalizability theory was used as a framework to assess reliability. Overall, SLI showed a relatively low level of trapezius muscle activity, but with little time at rest, and highly dynamic wrist motions. Electromyography exposure parameters showed poor to moderate reliability, while goniometry parameter reliability was moderate to excellent. For EMG parameters, performing repeated measurements on different days was more effective in increasing reliability than extending the duration of the measurement over one day. For goniometry, repeating measurements on different days was also effective in improving reliability, although good reliability could be obtained with a single sufficiently long measurement period.

Computer use associated with poor long-term prognosis of conservatively managed lateral epicondylalgia

STUDY DESIGN

Multicenter prospective design with a cohort of patients with lateral epicondylalgia commencing physical therapy.

OBJECTIVE

To identify key factors associated with long-term prognosis of conservatively managed lateral epicondylalgia.

BACKGROUND

The response to conservative management of lateral epicondylalgia is inconsistent and the rate of recovery varies widely among individuals. The reasons for these discrepancies are not understood. The identification of factors associated with prognosis will aid in the prediction of patient outcomes.

METHODS AND MEASURES

Sixty patients with lateral epicondylalgia, recruited from 9 sports medicine clinics and 2 hospital outpatient physical therapy departments in Ontario, Canada, were followed for 6 months. A baseline clinical assessment was conducted on each participant using standard physical therapy techniques. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and a 100-mm pain visual analog scale (VAS) were completed at baseline and 6 months later.

RESULTS

The key factor associated with both 6-month DASH and pain VAS scores was repetitive-work tasks (DASH, 9.8 [P < .011; pain VAS, 13.1 mm [P = .0105]). A subanalysis indicated that women were more likely than men to have cervical joint signs and, among women, positive cervical articular signs were also associated with higher final DASH and pain VAS scores.

CONCLUSIONS

Although many of the participants identified sports activities as the cause of their injury, these findings emphasize the importance that a patient's work tasks can have on recovery of lateral epicondylalgia. This would suggest that management should perhaps focus on work stations, postures, and behaviors.

Clinical signs and physical function in neck and upper extremities among elderly female computer users: the NEW study

The aim of the study was to present the prevalence of clinical signs and symptoms among female computer users above 45 years, both in a group with self-reported neck/shoulder trouble (NS cases) and in a group without such trouble (NS controls). The hypothesis was that computer users with self-reported neck/shoulder trouble have more clinical findings than those not reporting trouble, and that a corresponding pattern holds true for physical function. In total 42 and 61 questionnaire-defined NS cases and NS controls participated and went through a clinical examination of the neck and upper extremities and five physical function tests: maximal voluntary contraction (MVC) of shoulder elevation, abduction, and handgrip, as well as endurance at 30% MVC shoulder elevation and a physical performance test. Based on clinical signs and symptoms, trapezius myalgia (38%), tension neck syndrome (17%) and cervicalgia (17%) were the most frequent diagnoses among NS cases, and were significantly more frequent among NS cases than NS controls. A total of 60% of the subjects with reported trouble had one or several of the diagnoses located in the neck/shoulder. Physical function of the shoulder was lower in subjects with self-reported trouble as well as in the subgroup of NS cases with clinical diagnoses. In conclusion, the present clinical diagnoses and physical function tests differed between NS cases and NS controls, and are therefore recommended to be included as quantitative objective measures in assessing musculoskeletal health. Physical function tests should be further developed in order to be able to detect pre-stages of work-related disorders for preventive strategies.

Perceived muscular tension, job strain, physical exposure, and associations with neck pain among VDU users; a prospective cohort study

AIMS

To determine whether perceived muscular tension, job strain, or physical exposure are associated with increased risk of developing neck pain among VDU users.

METHODS

A baseline questionnaire was answered by 1283 respondents, of whom 671 were free from neck pain at baseline. Perceived muscular tension, job strain, and physical exposure were assessed at baseline. Information about newly developed neck pain was collected in 10 follow up questionnaires and the case definition was the first report of such pain in any of the follow up questionnaires. Median follow up time was 10.9 months.

RESULTS

Both men and women who perceived muscular tension at least a few times per week, compared to those who had not perceived muscular tension the preceding month, had an incidence rate ratio (IRR) of 1.9 (95% CI 1.25 to 2.93) for developing neck pain, when stratifying for sex. High perceived muscular tension was associated with an increased risk (IRR 1.6, 95% CI 1.02 to 1.91), even when controlling for job strain, physical exposure, and age in the model stratified by sex.

CONCLUSIONS

Perceived muscular tension was associated with an increased risk of developing neck pain among VDU users. The combination of high job strain and high perceived muscular tension was associated with higher risk of developing neck pain than the combination of high physical exposure and high perceived muscular tension. There was an indication of an excess risk due to interaction between high physical exposure and high job strain.

Trapezius muscle motor unit activity in symptomatic participants during finger tapping using properly and improperly adjusted desks

Work-related musculoskeletal disorders in the neck-shoulder area and upper extremities are common among computer users, especially women. We compared temporal changes of motor unit (MU) activation in the trapezius muscle during finger tapping using both appropriate and inappropriate ergonomic desk adjustments. Sixteen intensive and nonintensive computer users with either moderate or severe musculoskeletal disorders participated in the study. Six-channel intramuscular electromyographic (EMG) signals and 2-channel surface EMG were recorded from 2 positions of the trapezius muscle. A statistically significant increase in activity was observed with a desk adjusted 5 cm higher than appropriate and was attributable mainly to increased duration of MU activity. Participants with severe symptoms activated more MUs, and these were also active longer. In women, on average, MUs were active nearly twice as long as in men during the same tapping task. This study demonstrates that it is possible to evaluate ergonomic topics on the MU level and that incorrectly adjusted office equipment, in addition to motor demands imposed by the work task, results in prolonged activity of MUs. A potential application of this research is an increased awareness that certain individuals who work with incorrectly adjusted office equipment may be at greater risk of developing work-related musculoskeletal disorders.

Development of non-keyboard input device checklists through assessments

An assessment of non-keyboard input devices (NKID) was conducted to identify factors for good design in relation to operation, performance and comfort. Twenty-seven NKID users, working in health and safety, evaluated eight devices that included mice, trackballs and a joystick mouse. The factors considered important for good design were: (1) comfortable hand and finger position, (2) adequate control, (3) intuitive and easy to use, (4) ease of device, button and trackball movement, (5) good interaction with software, (6) provision of suitable accessories. Mice were rated more favourably than trackballs or the joystick mouse. The design of the standard 2-button mouse (D4) was considered most desirable to use; the 3-button mouse (D1) and 3-button curved mouse (D8) were also favoured. Assessment data and comments were drawn together with previously published research to produce useful tools for NKID purchasing (i.e. Device Purchasing Checklist) and assessment (i.e. Device Assessment Checklist).

Work related and individual predictors for incident neck pain among office employees working with video display units

AIMS

To investigate work related and individual factors as predictors for incident neck pain among office employees working with video display units (VDUs).

METHODS

Employees in three administrative units of a medium sized city in Finland (n = 515) received mailed questionnaires in the baseline survey in 1998 and in the follow up survey in 1999. Response rate for the baseline was 81% (n = 416); respondents who reported neck pain for less than eight days during the preceding 12 months were included into the study cohort as healthy subjects (n = 232). The follow up questionnaire 12 months later was completed by 78% (n = 180). Incident neck cases were those reporting neck pain for at least eight days during the preceding 12 months.

RESULTS

The annual incidence of neck pain was 34.4% (95% CI 25.5 to 41.3). Poor physical work environment and poor placement of the keyboard increased the risk of neck pain. Among the individual factors, female sex was a strong predictor. Smoking showed a tendency for an increased risk of neck pain. There was an interaction between mental stress and physical exercise, those with higher mental stress and less physical exercise having especially high risk.

CONCLUSION

In the prevention of neck disorders in office work with a high frequency of VDU tasks, attention should be given to the work environment in general and to the more specific aspects of VDU workstation layout. Physical exercise may prevent neck disorders among sedentary employees.

The impact of working technique on physical loads - an exposure profile among newspaper editors

The aim of this study was to investigate the possible associations between working technique, sex, symptoms and level of physical load in VDU-work. A study group of 32 employees in the editing department of a daily newspaper answered a questionnaire, about physical working conditions and symptoms from the neck and the upper extremities. Muscular load, wrist positions and computer mouse forces were measured. Working technique was assessed from an observation protocol for computer work. In addition ratings of perceived exertion and overall comfort were collected. The results showed that subjects classified as having a good working technique worked with less muscular load in the forearm (extensor carpi ulnaris p=0.03) and in the trapezius muscle on the mouse operating side (p=0.02) compared to subjects classified as having a poor working technique. Moreover there were no differences in gap frequency (number of episodes when muscle activity is below 2.5% of a reference contraction) or muscular rest (total duration of gaps) between the two working technique groups. Women in this study used more force (mean force p=0.006, peak force p=0.02) expressed as % MVC than the men when operating the computer mouse. No major differences were shown in muscular load, wrist postures, perceived exertion or perceived comfort between men and women or between cases and symptom free subjects. In conclusion a good working technique was associated with reduced muscular load in the forearm muscles and in the trapezius muscle on the mouse operating side. Moreover women used more force (mean force and peak force) than men when operating the click button (left button) of the computer mouse.

Computer use related upper limb musculoskeletal (ComRULM) disorders

Computer use has progressed fast in recent years. The symptoms and signs caused by repetitive computer use that is characterized by neck, shoulder, elbow, wrist and hand pain, paresthesia, and numbness can be called 'Computer Related Upper Limb Musculoskeletal (ComRULM) disorders'. Publications of recent 20 years have been reviewed. These disorders are usually multifactorial processes, caused by occupational, personal and social factors. Some suggestions concerning the diagnostics, procedures of prevention, and treatment options have been discussed. Further studies on 'ComRULM disorders' are necessary.

Computer mouse use in two different hand positions: exposure, comfort, exertion and productivity

The aim of this study was to determine whether there are differences in exposure, comfort, exertion and productivity between a neutral and a pronated hand position when using a computer mouse. Nineteen experienced VDU workers performed a standardised text editing task with each mouse hand position. The wrist positions and movements in the working arm were registered by an electrogoniometer and the muscle activity in the shoulder, two extensors in the forearm and the first dorsal interossei (FDI) was registered by electromyography. The subjects rated perceived exertion and comfort in work with each mouse hand position. Work with the neutral hand position, compared to the pronated, gave a decreased muscle activity in the extensors of the forearm and in the FDI and a trend indicating a decrease in the frequency of deviation movements in the wrist. At the same time, the subjects showed a decreased productivity and they rated less comfort in work with the neutral hand position.

Comparison of measurement accuracy between two wrist goniometer systems during pronation and supination

Pronation and supination have been shown to affect wrist goniometer measurement accuracy. The purpose of this study was to compare differences in measurement accuracy between a commonly used biaxial, single transducer wrist goniometer (System A) and a biaxial, two-transducer wrist goniometer (System B) over a wide range of pronation and supination (P/S) positions. Eight subjects moved their wrist between -40 and 40 degrees of flexion/extension (F/E) and -10 and 20 degrees of radial/ulnar (R/U) deviation in four different P/S positions: 90 degrees pronation; 45 degrees pronation; 0 degrees neutral and 45 degrees supination. System A was prone to more R/U crosstalk than System B and the amount of crosstalk was dependent on the P/S position. F/E crosstalk was present with both goniometer systems and was also shown to be dependent on P/S. When moving from pronation to supination, both systems experienced a similar extension offset error; however R/U offset errors were roughly equal in magnitude but opposite in direction. The calibration position will affect wrist angle measurements and the magnitude and direction of measurement errors. To minimize offset errors, the goniometer systems should be calibrated in the P/S posture most likely to be encountered during measurement. Differences in goniometer design and application accounted for the performance differences.

Physical workload on neck and upper limb using two CAD applications

The aim was to evaluate (1) the physical workload on neck and upper limb in computer-aided design (CAD) work; (2) the impact of two applications (PROFESSIONAL-CADAM and PRO/Engineering) and (3) two input devices (computer mouse and keyboard), as well as (4) sitting and standing work positions. Fifteen CAD operators were interviewed and examined physically. For nine subjects, the physical workload was measured: electromyography (EMG) of trapezius and forearm extensor muscles, inclinometry of the head, the upper back and upper arms, as well as wrist goniometry. The muscular load was low in CAD work, but the inter-individual variation was considerable. Neither the positions were extreme, nor the movements. The applications, per se, did not have a large impact on the workload, but because of the need for different input devices the effect was strong. Using a keyboard meant higher angular velocities than using a mouse. Hence, when choosing a new software, which requires mainly a mouse as input device, this has to be balanced against the risk of disorders.