Effect of Setup Configurations of Split Computer Keyboards on Wrist Angle

Alternative computer keyboards whose halves can be slanted toward each other can reduce a risk factor (ulnar deviation) for work-related musculoskeletal disorders (WMSDs) affecting the upper limbs. Two questions that computer keyboard operators face when using keyboards that can be separated into halves (split keyboards) are: (1) At what angle should the keyboard halves be opened? and (2) At what distance apart should the keyboard halves be placed? The objective of this study was to investigate the effects of the opening angle and separation distance between halves of a split keyboard on wrist ulnar deviation and typing efficiency. Methods. Eleven experienced computer keyboard operators participated in this study and used a split keyboard that was set up in a conventional (nonsplit) format and also in 3 alternative configurations: (1) centers of keyboard halves were separated at 20-cm distance, (2) keyboard halves were separated half of the distance of shoulder width, and (3) keyboard halves were separated at shoulder width distance. Results. The 3 alternative configurations resulted in ulnar deviation of both wrists that were less than ulnar deviation from typing on a conventional setup. There were no differences in ulnar deviations among the 3 alternative configurations. Discussion and Conclusion. The results of this research provide physical therapists and ergonomists with a set of configurations of a split keyboard that they can recommend to their patients or clients. All of the alternative configurations of the split keyboard are beneficial in promoting a neutral wrist position, which theoretically would decrease exposure to WMSDs such as tenosynovitis in the wrist and carpal tunnel syndrome. [Marklin RW, Simoneau GG. Effect of setup configurations of split computer keyboards on wrist angle. Phys Ther. 2001;81:1038 –1048.

A Standardized Evidence-Based Model of Orthopaedic Physical Therapy Practice: A Quest for the Holy Grail?

The growth of knowledge in orthopaedic physical therapy practice is on an exponential trajectory. This growth is occurring simultaneously for many aspects of evidence-based practice: diagnosis, prognosis, treatment, and harm – with increasingly more sophisticated basic science and mechanistic studies guiding and supporting the clinical research endeavors. Just how close are we to the day when we can clearly establish the accuracy of our diagnoses, regardless of the model used, and then can confidently inform our patients of the most effective treatment approach and the expected outcomes, as well as any potential harm? This knowledge is being created now, and the ability to assemble and transmit that information effectively to current and future clinicians is evolving. In time, I expect that orthopaedic physical therapy practice will become truly evidence based and standardized around the globe – so that the first line of intervention for a given patient with a specific diagnosis is reasonably agreed upon. Despite the considerable challenges that remain, every day we are getting closer to achieving this vision

Effect of Computer Keyboard Slope on Wrist Position and Forearm Electromyography of Typists Without Musculoskeletal Disorders

Positioning a computer keyboard with a downward slope reduces wrist extension needed to use the keyboard and has been shown to decrease pressure in the carpal tunnel. However, whether a downward slope of the keyboard reduces electromyographic (EMG) activity of the forearm muscles, in particular the wrist extensors, is not known. Subjects and Methods. Sixteen experienced typists participated in this study and typed on a conventional keyboard that was placed on slopes. Electromyographic activity of the extensor carpi ulnaris (ECU), flexor carpi ulnaris (FCU), and flexor carpi radialis (FCR) muscles was measured with surface electrodes, while the extension and ulnar deviation angles of the right and left wrists were measured with electrogoniometers. Results. Wrist extension angle decreased from approximately 12 degrees of extension while typing on a keyboard with a 7.5-degree slope to 3 degrees of flexion with the keyboard at a slope of –15 degrees. Although the differences were in the range of 1% to 3% of maximum voluntary contraction (MVC), amplitude probability distribution function (APDF) of root-mean-square EMG data points from the ECU, FCU, and FCR muscles varied across keyboard slopes. Discussion and Conclusion. Wrist extension decreased as the keyboard slope decreased. Furthermore, a slight decrease in percentage of MVC of the ECU muscle was noted as the keyboard slope decreased. Based on biomechanical modeling and published work on carpal tunnel pressure, both of these findings appear to be positive with respect to comfort and fatigue, but the exact consequences of these findings on the reduction or prevention of injuries have yet to be determined. The results may aid physical therapists and ergonomists in their evaluations of computer keyboard workstations and in making recommendations for interventions with regard to keyboard slope angle. [Simoneau GG, Marklin RW, Berman JE. Effect of computer keyboard slope on wrist position and forearm electromyography of typists without musculoskeletal disorders. Phys Ther. 2003;83:816–830.

Walker-Assisted Gait in Rehabilitation: A Study of Biomechanics and Instrumentation

While walkers are commonly prescribed to improve patient stability and ambulatory ability, quantitative study of the biomechanical and functional requirements for effective walker use is limited. To date no one has addressed the changes in upper extremity kinetics that occur with the use of a standard walker, which was the objective of this study. A strain gauge-based walker instrumentation system was developed for the six degree-of-freedom measurement of resultant subject hand loads. The walker dynamometer was integrated with an upper extremity biomechanical model. Preliminary system data were collected for seven healthy, right-handed young adults following informed consent. Bilateral upper extremity kinematic data were acquired with a six camera Vicon motion analysis system using a Micro-VAX workstation. Internal joint moments at the wrist, elbow, and shoulder were determined in the three clinical planes using the inverse dynamics method. The walker dynamometer system allowed characterization of upper extremity loading demands. Significantly differing upper extremity loading patterns were Identified for three walker usage methods. Complete description of upper extremity kinetics and kinematics during walker-assisted gait may provide insight into walker design parameters and rehabilitative strategies

Effect of Keyswitch Design of Desktop and Notebook Keyboards Related to Key Stiffness and Typing Force

This study aimed to compare and analyse rubber-dome desktop, spring column desktop and notebook keyboards in terms of key stiffness and fingertip typing force. The spring-column keyboard resulted in the highest mean peak contact force (0.86N), followed by the rubber dome desktop (0.68N) and the notebook (0.59N). All these differences were statistically significant. Likewise, the spring-column keyboard registered the highest fingertip typing force and the notebook keyboard the lowest. A comparison of forces showed the notebook (rubber dome) keyboard had the highest fingertip-to-peak contact force ratio (overstrike force), and the spring-column generated the least excess force (as a ratio of peak contact force). The results of this study could aid in optimizing computer key design that could possibly reduce subject discomfort and fatigue

Biomechanical Effects of Mobile Computer Location in a Vehicle Cab

Objective: The objective of this research is to determine the best location to place a conventional mobile computer supported by a commercially available mount in a light truck cab. Background: U.S. and Canadian electric utility companies are in the process of integrating mobile computers into their fleet vehicle cabs. There are no publications on the effect of mobile computer location in a vehicle cab on biomechanical loading, performance, and subjective assessment. Method: The authors tested four locations of mobile computers in a light truck cab in a laboratory study to determine how location affected muscle activity of the lower back and shoulders; joint angles of the shoulders, elbows, and wrist; user performance; and subjective assessment. A total of 22 participants were tested in this study. Results: Placing the mobile computer closer to the steering wheel reduced low back and shoulder muscle activity. Joint angles of the shoulders, elbows, and wrists were also closer to neutral angle. Biomechanical modeling revealed substantially less spinal compression and trunk muscle force. In general, there were no practical differences in performance between the locations. Subjective assessment indicated that users preferred the mobile computer to be as close as possible to the steering wheel. Conclusion: Locating the mobile computer close to the steering wheel reduces risk of injuries, such as low back pain and shoulder tendonitis. Application: Results from the study can guide electric utility companies in the installation of mobile computers into vehicle cabs. Results may also be generalized to other industries that use trucklike vehicles, such as construction

The capacity of short-chain fructo-oligosaccharides to stimulate faecal bifidobacteria: a dose-response relationship study in healthy humans

BACKGROUND: Short-chain fructo-oligosaccharides (scFOS) are well-known for their bifidogenicity. In a large study comprising 200 healthy volunteers, we determined the bifidogenic properties of 7 non-digestible carbohydrates administered at a dose of 10 g/d in the diet; we analysed dose-response relationships of the bifidogenic substrates at doses ranging from 2.5 to 10 g/d in comparison with a placebo. The aim of this presentation is to give more details about the dose-response effects of short-chain fructo-oligosaccharides (scFOS). METHODS: Forty healthy volunteers (18 males, 22 females) eating their usual diets were randomly divided into 5 groups of 8 subjects and received scFOS at a dose of 2.5, 5.0, 7.5 and 10 g/d or a placebo for 7 d. Stools were collected before (day (d) 8) and at the end (day (d) 15) of sugar consumption, and tolerance was evaluated using a daily chart. RESULTS (M ± SEM): Bifidobacteria counts increase was higher in scFOS than in placebo group for all doses tested [2.5 g/d (from 9.15 ± 0.59 to 9.39 ± 0.70; P = 0.02); 5 g/d (from 10.21 ± 0.21 to 10.67 ± 0.22; P = 0.03); 7.5 g/d (from 9.28 ± 0.49 to 9.85 ± 0.35;P = 0.01); 10 g/d (from 9.00 ± 0.81 to 10.18 ± 0.60; P = 0.003)]. A significant correlation between the ingested dose of scFOS and faecal bifidobacteria counts was observed at d15 (r(2 )= 0.307, P < 0.001). Total anaerobes increased at the dose of 10 g/d. No significant differences were found for Bacteroides, Lactobacillus, enterobacteria or pH in any group. The frequency of digestive symptoms was not different between scFOS at any of the doses tested and placebo. Bloating was significantly more intense during scFOS ingestion at doses of 2.5 and 5 g/d, but not at doses of 7.5 and 10 g/d. Excess flatus, borborygmi and abdominal pain did not differ from the placebo at any of the doses tested. CONCLUSION: This study showed that scFOS is bifidogenic and well tolerated at doses ranging from 2.5 to 10 g/d, and that there is a dose-response relationship in healthy volunteers