Nancy A. Baker, Elyse L. Aufman, Janet L. Poole; Computer Use Problems and Accommodation Strategies at Work and Home for People With Systemic Sclerosis: A Needs Assessment. Am J Occup Ther 2012;66(3):368-375. doi: 10.5014/ajot.2012.003467.
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© 2017 American Occupational Therapy Association
OBJECTIVE. We identified the extent of the need for interventions and assistive technology to prevent computer use problems in people with systemic sclerosis (SSc) and the accommodation strategies they use to alleviate such problems.
METHOD. Respondents were recruited through the Scleroderma Foundation. Twenty-seven people with SSc who used a computer and reported difficulty in working completed the Computer Problems Survey.
RESULTS. All but 1 of the respondents reported one problem with at least one equipment type. The highest number of respondents reported problems with keyboards (88%) and chairs (85%). More than half reported discomfort in the past month associated with the chair, keyboard, and mouse. Respondents used a variety of accommodation strategies.
CONCLUSION. Many respondents experienced problems and discomfort related to computer use. The characteristic symptoms of SSc may contribute to these problems. Occupational therapy interventions for computer use problems in clients with SSc need to be tested.
What types of problems do people with SSc most frequently experience with equipment during computer use?
To what degree do problems with equipment affect computer use in people with SSc?
What types of accommodation strategies do people with SSc use to alleviate problems during computer use?
Occupational therapists working with this population should work with clients to identify environmental accommodations, rather than changes in performance, to reduce disability.
Interventions for people with SSc should focus first on the keyboard and mouse, whereas interventions for people with other types of arthritis should focus first on the chair.
Reconfiguring the workstation to match the anthropometrics of the worker can help reduce pain and fatigue.
Many alternative keyboards have fixed angles to reduce pronation, ulnar deviation, and wrist extension, and some keyboards can be adjusted to match the limitations of the hands. Keyboards with larger keys or keyguards may help reduce errors. Given the tendency for digital ulcers in this population, computer users who have SSc should use keyboards with a soft touch.
Users can be taught to use keyboard shortcuts to reduce mouse use. Using word processing functions such as “stickykeys,” which allows users to operate multiple keys simultaneously by pressing keys one at a time, can enhance the use of shortcuts and reduce mouse use. Many input devices are angled to reduce hand pronation and to place the wrist and fingers in neutral positions. An input device that eliminates grasping, such as a trackball, may also reduce fatigue.
Our sample reported problems with cold, particularly during mouse use, attributable to Raynaud’s phenomenon. Heated keyboards and mice can address this issue.
To address the fatigue reported by our sample and in other studies (Sandqvist et al., 2010; Sandusky, McGuire, Smith, Wigley, & Haythornthwaite, 2009), practitioners can provide computer operators who have SSc with education on energy conservation techniques and software reminders to take regular, short breaks.
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