Slashdot Mirror
Input Solutions for Repetitive Stress Victims?
simiproject asks: "I provide IT consulting for a 30-person organization. Recently, I have been trying to find an acceptable keyboard/mouse solution for a staff member who experiences sharp pains in her thumb, hand and arm when using her mouse. She had been using one of those 3M joystick mice and felt it only made her situation worse since it required even more extension of her thumb. Holding a pen or stylus won't work since that requires gripping. I switched her to a trackball mouse and that helped a little but not much. However, trying to find a solution that doesn't require using the thumb is like shopping in a bizarro world where we just didn't evolve with that opposing digit. I'd be interested in what practical input solutions Slashdot has for a computer user with limited hand mobility. Voice recognition? Laptop-like touch pads (I've looked but haven't found any)?"
They might ask you the URL, mighten they? http://www.footmouse.com/
-- "In order to have power, I must be taken seriously." -Mojo Jojo
Same sorta thing came up with my supervisor...
Long story short....He had to relearn how he used his mouse to avoid problems.
It came to this because quite frankly no one designed something to suit his individual finger mobilty limit, mainly due to the fact that just about everyone in this situation is unique, each having their own limits, tonerances, and ability.
Switch mousing hands, worked like a charm for me. While I'll never be as fast or accurate now that I'm a lefty, it's more than adequate for typical office software. I did have to give up the FPSes though.
She could go for the reflective dot on the forhead and webcam tracking software, but this was too geeky even for me. Check her Star Trek quotient before impelmenting.
How did you not manage to find any laptop-like touch pads? Did it occur to you to go to this awesome new site, type in "touch pads", and click "I'm feeling lucky"? You would have gotten here.
I've had this sig for three days.
adesso
Just the first two found from a googling. Trackpad or touchscreen would seem the obvious solutions to me.cirque
Never underestimate the dark side of the Source
Logitech makes a sort of trackball they call a "marble mouse". Perhaps it's the kind you've already tried, but I thought it was worth a mention. You can see some info from their site. The bottom line it that it's a trackball that you operate with your index (and/or middle) finger rather than your thumb (as is traditional). I still use my thumb to click buttons, but it's a lot less work. If that's an issue, you can probably configure the computer to reverse left and right clicks, which would make the action even less frequent. I found it a bit akward to use at first, but I got used to it pretty quickly.
"You call it a new way of thinking; I call it regression to ignorance!" -- Operation Ivy
Seriously. He should try putting the mouse on the floor and moving it around with his foot. Manipulating mouse buttons doesn't really require a lot of manual dexterity.
On the whole, though, this is a very tricky issue. A friend of mine has really bad repeat stress injury and there's no easy way to "fix" it. The way to get better is to cease doing the activity that messed you up to begin with. In this modern world it seems a little inconceivable that you'd go without using a computer -- perhaps for years -- but that might be what it takes. Lousy, but would he rather stay injured the rest of hia life?
Breakfast served all day!
Man...victimized by a 3M joystick mouse. What is the IT world coming to?! :P
Cut off her thumb! No more problem.
I reserve the right to think for myself. Others' opinions are optional. Puppy on lap = typos...not illiteracy.
I have the same problem myself. After trying numerous things I've found that the Evoluent vertical Mouse 2 works, as the hand is at a completly different angle than a normal mouse, trackball or touchpad. I also use a Futuro RSI wrist strap which limits the movement in the wrist and forces me to keep it at the correct angle etc for the keyboard.
Simple question - Is she holding the mouse properly? (Don't take this as a condesending question - no one ever teaches people how to hold/use a mouse and ergonomics is very important - humans just aren't naturally designed to sit in chairs all day long). Pain such as this can often be caused by having the arm at the wrong angle causing the wrist to be twisted at an odd angle for long hours.
Instead of just looking at the mouse, I'd suggest looking at her complete desk/chair/keyboard setup. Starting at the bottom and working your way up.
Chair
Her chair should be such that her feet comfortably touch the ground when the knees are bent at about 90 (ie. not dangling and not cramped backwards/stretched forward) and her back is straight and comfortably supported. This should then put her elbows at about level of the desk surface.
Desk
Get her to place her hands on the keyboard with her shoulders relaxed and her forearms should be able to rest along the desk surface (alot of people have their keyboard too close cramping up their shoulders and causing the elbows to stick out and wrists to be twisted... move the keyboard back towards the monitor until its at a good comfortable length). Do the same for the mouse and get her to hold it.
Mouse
Since her arm is now relaxed and stretched out, the base of the mouse should rest under the palm of the hand, with the base of the palm resting on the mousepad, so the fingers naturally stretch forward over the buttons. Alot of people hold mice incorrectly from above and then move it with their wrist. The wrist shouldn't actually move much (it wiggles a bit) but most of the movement actually coming from small movements of the elbow/shoulder (which translate to larger movements of the forearm which transfer through the base of the palm to the mouse - basically her watch should move in sync with the mouse and not sit still).
Once all this is done and correct then you can check if the mouse if comfortable or not (I had one mouse which was too tall (meant for a bigger hand or just bad design) and I noticed the effect after a week as my wrist was tilted back just a fraction too much).
In both this article and the one about standing vs. sitting at work, I see endless well-intentioned posts from people saying, "this is how you fix your problem." Almost always, it means (and often actually says) "this is how I fixed my problem, so you should do it to."
Bottom line here folks is that what works for you might not work for me. Your ideal mouse isn't mine. Your wrist problems might in fact be caused by the same thing as my back problems and buddy's thumb problems, with the only difference being in how we've adapted to a flawed situation. Alternatively, what caused your thumb problem (and hence what fixed it) might not be even remotely related to what caused my nearly-identical thumb problem, and so the same fix might not work.
The best advice you can get is to start with a standard configuration, identify the problem, and then explore as many potential fixes until you find the one that works. This is not an exact science! There are no single, deterministic solutions to each problem!
So in short, consider every solution offered with a grain of salt--but do consider it.
"People who do stupid things with hazardous materials often die." -- Jim Davidson on alt.folklore.urban
Use the other hand.
I reserve the write to mangle english.
Since use of the thumb is a big issue, I'd suggest showing her a built-in usability function that comes with windows, MouseKeys. When turned on it converts the number keys into mouse function keys (movement, single click, double click, drag, drop, etc). Now normally this is used to avoid all use of the mouse, but can be a little slow moving the cursor around. In your case thought it would allow moving the mouse with the right hand and using the left hand to do the clicking/dragging. Personally I use it a lot just because using the keyboard keys is a lot less stressful than clicking the mouse keys because you don't have to grip in order to push the buttons and there's less strain, especially when you have a lot of repeated clicking in a short period. There's of course a period of adjustment before it becomes second nature to use Mousekeys but it's a no cost, effective solution. And you can toggle it on and off just using the NUM Lock key so you still have access to the number pad for number entry.
p /mousekeys.aspx
i ning/windows95/mouse.html
Here is a link to Microsofts description of how to turn them on:
http://www.microsoft.com/enable/training/windowsx
and a nice tutorial on what keys do what and tweaks:
http://www.disability.uiuc.edu/infotechaccess/tra
Use your feet to click your mouse.
Seriously. Get a Smart Joy adapter and a Reload Pedal, and remap the joystick input to mouse click... though you may have to unscrew the top and cut the spring in half for easier clicking, like I did. Alternatively, get a mouse with very large buttons, remove the trackball / tape over the sensor, and leave it on the floor as a secondary mouse. Both sets of clicks will register.
The key to RSI, is to not find one "optimal" solution. Switch keyboards and mice throughout the day. Change your position completely. Walk over and talk to someone about a spec they had written. Put your feet up. Take your feet down. Really, the reason we get RSI is because we do one thing repeatedly. No matter how ergonomic that one sitting position or wrist angle may be, if you stay fixed in that position eventually your ligaments and joints will break down. Change position, take coffee breaks, mouse lefty for a little, turn your body to the side... anything to keep from falling into the trap of the one perfect body position.
The ______ Agenda
Most people have horrible posture when typing, resting their arms on corners, extending their hands far out to the right (past the vestigal number pad) to mouse, keeping their head at an awkward angle that distorts their spine's natural curves..
First off, she should listen to her body. If something hurts, stop doing it. This is the fair warning that her body is giving her. She can take breaks-- walk once around the building, refill her water glass, stretch in place, shake her hands. Use a timer in Outlook that goes off every twenty minutes at first until the symptoms show continued improvement.
Second, she should avoid Repetive Motions as much as possible. Break the habit. Mix things up frequently.
* Switch mousing hands regularly.
* Always rest hands in the lap.
* Adjust or fix the lighting. (reduces muscle tension and eye strain)
* Adjust the monitor height.
* Switch out the effing keyboard for something without an attached number pad.
* Get a keyboard that is the right size for her body frame.
* Attach multiple mice to her system for instant switching.
* Get an adjustable keyboard tray.
* Learn and use keyboard shortcuts.
* Change positions several times a day.
* Get an adjustable monitor stand. (and replace the monster CRT with an LCD)
* Automate her crap work.
Touchpad mice let her use her thumb, pinky, palm, even her knuckles if her hand is being too sensitive. It's easy enough to attach both a touchpad and a normal (but ergonomic) mouse to the system so that she can switch between them according to the action/gesture and what her hand is feeling that moment.
I'm pissed that I missed the boat on the Touchstream keyboard/mice/touchpads, but the TypeMatrix keyboards are a great second-place winner. The keyboards come in a small and large size, with the small one suitable for most people. They also fit correct posture more naturally, by getting rid of the oh-so-stupid staggered key layout, and by separating the left and right sizes a little, and adding extra enter/backspace keys in the center for good measure.
I got one for someone at our work with chronic pain, and she had no problem adjusting to the new layout in hours. Her condition has improved a lot, and she credits the keyboard and better lighting. (I tried to get her to use a touchpad mouse, but it completely ignored her touch.)
At my desk, I have the TypeMatrix keyboard, a regular mouse for precision-work, and a Cirque touchpad for normal mousing. (The touchpad is 9 years old, and still works great.) I put a large box on the side table so that I can also stand and use my personal laptop for the 40% of my work that is internet crap and web-development. When I'm web browsing (er, researching), I can actually kick back in my chair, and do everything just with the touchpad. Change positions!
(I have considered the Kenesis split keyboard but it was too big and pricey for me at the time. I call it a fine third choice.)
Everyone is entitled to his own opinions, but not his own facts.
Specifically, this one
I used to spend 8 hours a day sitting on my specially-ordered ergonomic chair, tapping away at my ergonomic keybaord, wearing wrist supports, popping pain killers, and contemplating quitting my job because I had RSI in both wrists so badly my hands actually burned with pain. I started the excercises listed for wrist pain in that book one weekend, and when I came back to work on Monday, I chucked my wrist supports into my desk drawer, along with my painkillers, and never used them again. The chair went back to the suppliers a few days later.
RSI is *not* caused by too much movement - the body exists for no other purpose than movement, and it was "designed" for a hell of a lot more movement than we give it by sitting in chairs all day. The cause of RSI is *bad* movement: Movement in a bad posture, using the wrong muscle groups, etc. A primary cause of my burning hands was that I typed with my hands bent back so the tendons in my forearm were scraping over the bones, rubbing them raw: sitting up straighter so my hands naturally bent forward/downward eliminated 90% of my pain overnight.
The problem is with the body, not the office equipment. So don't waste your money on a new mouse: Fix the real problem.
So.. it has come to this
Most RSIs aren't caused by the device being used. They're caused by poor workstation ergonomics in general. Start with her posture. Is she sitting with her feet flat on the floor, knees bent at about 90 degrees? Are her chair arms removed or set as low as possible? Ideally, she shouldn't rest her elbows, wrists, or the heels of her hands on anything while typing. When typing, her elbows should be close to her body and bent at about 90 degrees also. Given the posture constraints, her keyboard and mouse height will likely have to be adjusted. It's important to adjust the height of the equipment, not the height of the chair. Raising the chair will raise her legs, causing her to adjust her posture away from the optimum. For sensitive users, such as this person seems to be, you need to throw away all those wrist rests, pads, and other items that may put pressure on or near the carpal tunnel area. Even those swoopy microsoft keyboard, with the huge, non-removable wrist rest aren't very good for truly sensitive types. Correct posture of the legs, back, arms, and wrists is the real solution.
I had huge problems with my wrists, for years. I finally went to work for a company big enough to have an ergonomics specialist. When I mentioned it to my boss, he immediately called her, and she came to my office to assess the situation. After a *long* lecture about posture, she took away all my so-called ergonomic gear. She then had the facilities guys come install a height-adjustable keyboard tray and bring me a new chair (Aeron, w00t!). Once everything was adjusted, the problem pretty quickly went away on its own. The only thing that I do now that's exceptional is that I use a trackpoint keyboard at home (from http://pckeyboards.com/).
I have been suffering from RSI for about a year now and found some things that help.
Voice control software. I use ViaVoice myself. It is a real pain to train, but once done it is very good for emails, documents and the like. Probably too unwieldy for a total replacement, but it can reduce the typing load.
RSIGuard a handy program that forces you to take breaks based on how much you have used the mouse or keyboard. Simple idea, but it is so easy to forget to take breaks.
Aerobic Mouse or Quill Mouse. If gripping a pointing device is the problem this is great. Its like a vertical mouse and your hand sits in a tray on the side of it. You can move it around and keep the hand relaxed.
For further reading:
What, me worry?
She needs to see an orthopedic surgeon NOW!!!!!!
I have the same problem: changing hands is initially awkward, but it helps.
Check her posture ... any reaching forward aggravates the tendons. Ergonomics must be perfect.
A keyboard with integrated touchpad would allow her to use fingertips instead of thumb ... might help.
She needs to REST NOW or this can turn into a permenent problem! And a wrist splint that immobilizes the thumb (the low-cost equivalent is to tape the thumb to the hand). Wearing wrist braces as much as possible
Taking painkillers is counterproductive unless you take painkillers AND rest ... painkillers without rest allows you to continue damaging the tendons and by the time the damage is so great the painkillers don't work, the tendons might be beyond recovery.