Help workers with ergonomic troubles
Therapists can provide prevention assessments
Rehab facilities can open up a whole new market niche if they can convince major companies with large numbers of office workers, such as banks and newspapers, to contract for prevention programs on ergonomic hazards.
"We’re trying to reduce ergonomic exposure and risk of injuries, and one of the big things we do with that lately has been working with people who use computers," says Mary Ellen Modica, MHS, PT, director of Steps Rehabilitation Clinic in Arlington Heights, IL. The clinic is part of Schwab Rehab.
"We readjust monitors, chairs, computer stations to reduce carpal tunnel, tendonitis, neck problems, and back problems," Modica says. "We analyze each worker at the workstation, identify the risk, such as a bad position that puts excessive pressure on their muscles, tendons, and nerves, and then we suggest they change the monitor, lower the keyboard, etc."
Sample assessments
Here are some examples from assessments written by the rehab facility’s therapists:
o A computer workstation in an engineering department.
Risk factors:
A. Present keyboard is stationary and does not adjust to the worker’s resting elbow height or provide adequate wrist support. This causes increased compression of the elbow on the armrest and sustained excessive wrist extension.
B. Monitor height is not adjusted to the worker’s eye height. Screen is positioned 4.5 inches too low, possibly causing the worker to maintain sustained neck flexion and increased postural stress. The worker’s eye height should be level with the top of the screen.
C. Monitor is positioned a significant distance off to the right, increasing cervical rotation. Computer screen is located at a distance of 50 inches from the worker’s eye. Average comfort zone is within 18 inches to 28 inches.
D. Document holder is not provided, contributing to excessive cervical rotation, flexion, and lateral trunk flexion.
E. Drafting table may be lowered approximately 1 inch to prevent sustained and excessive shoulder elevation while performing work tasks in a sitting position. While utilizing the drafting table in a standing position, the worker may experience back discomfort with rounding of the neck and thoracic area.
Corresponding recommendations:
A. Provide the worker with a hand-adjustable keyboard tray and a gel wrist support. This would allow the worker to maintain elbows at resting height and facilitate neutral positioning of the wrist.
B. Monitor height should be raised 4.5 inches to align the worker’s eye height with the top of monitor. The worker’s eye height should be level with the top of the screen.
C. Monitor should be positioned directly in front of the worker to prevent excessive cervical flexion and rotation. Screen should be placed within the average comfort zone of 18 inches to 28 inches.
D. Provide the worker with a document holder that attaches to the top of the monitor so it is in the worker’s line of vision to eliminate eye strain and possible neck fatigue.
E. Lower the drafting table 1 inch to maintain shoulders and elbows in proper resting height. The worker should have access to a foot rest and be encouraged to place one foot on the foot rest while utilizing the drafting table in a standing position. This will relieve back discomfort and facilitate erect standing posture.
Equipment recommendations:
1. Adjustable keyboard holder.
2. Gel-type wrist support.
3. VuRisers — 1-inch or 2-inch increments.
4. Document holder.
5. Adjustable footrest.
o A museum’s computer workstation.
Risk factors:
A. Monitor height not equal to the worker’s eye height. Monitor height is approximately 2.5 inches higher than the worker’s eye height, thus not allowing for an ideal sitting posture, causing worker to maintain neck extension. The placement of the VDT monitor to the right of the worker places additional stress on the worker, causing constant rotation of the head and neck.
B. Document holder not provided. This places increased postural stress to the worker’s upper back and neck as papers are placed on the work surface, resulting in head and neck flexion.
C. There is not enough room for tasks to be performed in the work area. Placement of the hard drive on the work surface and lack of documentation holder also contribute to poor space utilization.
D. Poor lighting at the workstation may make it difficult for the worker to perform visually demanding tasks. The current reading of 12-foot candles is significantly lower than the required standard, according to the American National Standards Institute, for VDT terminals, which is between 19- and 46-foot candles. This can cause visual strain as well as postural stress to the neck and upper back.
E. Work area not free from distraction due to workstation being set in community office area.
Corresponding recommendations:
A, B, C. To eliminate those risk factors, the current, non-adjustable computer station needs to be replaced with a completely adjustable table. Then the workstation can be rearranged so the monitor is directly in front of the worker; the hard drive can be placed below the work surface, and a document holder can be provided so the top of the document is equal to the worker’s eye height.
With an adjustable keyboard tray as a component of the new table, the keyboard height can be raised 2.5 inches, as well as raising the worker, without compromising thigh clearance under the work surface. Because the worker is raised, a footrest should be provided so the worker can maintain proper sitting posture.
D. Provide the worker with task lighting for performance of visually demanding tasks or increase overhead lighting.
Equipment recommendations:
1. Fully adjustable computer workstation.
2. Document holder.
3. Task lighting.
Need More Information?
Mary Ellen Modica, MHS, PT, Director of Steps Rehabilitation Clinic, 2400 East Oakton, Suite 110, Arlington Heights, IL 60005. Phone: (847) 806-0900.
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