Journal of Occupational Rehabilitation

, Volume 20, Issue 1, pp 59–68 | Cite as

The Association Between Rheumatoid Arthritis Related Structural Changes in Hands and Computer Keyboard Operation

  • Nancy A. Baker
  • Norman P. Gustafson
  • Joan Rogers
Article

Abstract

Introduction This cross-sectional study examined the effect of structural changes caused by rheumatoid arthritis (RA) on computer keyboarding style to provide insights on how changes may affect worker performance. Method Computer keyboarding styles, as measured by the keyboard-personal computer style instrument, were compared between 45 keyboard operators with RA and 29 without. A severity of structural changes score (SSCS) was assigned after recruitment by observing subjects’ hands while operating a keyboard. Significant differences between each item of keyboarding style by diagnosis were identified through Chi square analyses. Logistic regression models with age, diagnosis, SSCS, and touch typing training as the predicators further evaluated the effect of structural changes on each item of personal keyboarding style. Results Significantly more keyboard operators with RA used high force keystrokes, did not use a wrist rest, moved their hands to strike keys, maintained their wrists and fingers in a fixed position and used fewer than two fingers to activate keys. The amount of variance explained by each model varied from 8 to 56%. SSCS was the most common predictor of keyboarding style (54% of significant models), followed by age (35% of significant models), diagnosis (19% of significant models), and touch typing training (15% of significant models). Conclusion Severity of structural changes and age are significant predictors of keyboarding style for computer operators with RA. The keyboarding styles used by computer operators with RA appear to reduce typing productivity and have the potential to put stress on joints already affected by RA. Computer operators with RA may benefit from worksite modifications that address keyboarding style such as alternate keyboards.

Keywords

Occupational health Biomechanics Arthritis Joint disease Typing Productivity 

References

  1. 1.
    Trybus M, Lorkowski J, Brongel L, Hladiki W. Causes and consequences of hand injuries. Am J Surg. 2006;192:52–7.CrossRefPubMedGoogle Scholar
  2. 2.
    Bureau of Labor Statistics. Number and percent of nonfatal occupational injuries and illnesses involving days away from work resulting from repetitive motion, occupations with one percent or more of total cases, 2007. 2008 [cited 2009 June 4]; Available from: http://www.bls.gov/iif/home.htm.
  3. 3.
    Wong JYP. Time off work in hand injury patients. J Hand Surg-AM. 2008;33A:718–25.CrossRefGoogle Scholar
  4. 4.
    Gustafson M, Ahlstrom G. Problem experienced during the first year of an acute traumatic hand injury—a prospective study. J Clin Nurs. 2004;13:986–95.CrossRefGoogle Scholar
  5. 5.
    Allaire SH. Update on work disability in rheumatic diseases. Curr Opin Rheumatol. 2001;13:93–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Reisine S, Fifield J, Walsh SJ, Feinn R. Factors associated with continued employment among patients with rheumatoid arthritis: a survival model. J Rheumatol. 2001;28:2400–8.PubMedGoogle Scholar
  7. 7.
    Verstappen SMM, Bijlsma JWJ, Verkleij H, Buskens E, Blaauw AAM, ter Borg EJ, et al. Overview of work disability in rheumatoid arthritis patients as observed in cross-sectional and longitudinal surveys. Arthritis Rheum. 2004;51:488–97.CrossRefPubMedGoogle Scholar
  8. 8.
    Yelin E, Henke C, Epstein W. The work dynamics of the person with rheumatoid arthritis. Arthritis Rheum. 1987;30:507–12.CrossRefPubMedGoogle Scholar
  9. 9.
    Allaire S, Wolfe F, Niu J, Lavalley M. Contemporary prevalence and incidence of work disability associated with rheumatoid arthritis in the US. Arthritis Rheum (Arthrit Care Res). 2008;59:474–80.CrossRefGoogle Scholar
  10. 10.
    Kauranen K, Vuotikka P, Hakala M. Motor performance of the hand in patients with rheumatoid arthritis. Ann Rheum Dis. 2000;59:812–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Hakala M, Nieminen P, Manelius J. Joint impairment is strongly correlated with disability measured by self-report questionnaires; functional status assessment of individuals with rheumatoid arthritis in a population based series. J Rheumatol. 1994;21:64–9.PubMedGoogle Scholar
  12. 12.
    Van Lankveld WGJM, Van‘t Pad Bosch P, Van De Putte L. Predictors of changes in observed dexterity during one year in patients with rheumatoid arthritis. Br J Rheumatol. 1998;37:733–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Allaire S, Wolfe F, Niu J, Baker NA, Michaud K, LaValley MP. Extent of occupational hand use among persons with rheumatoid arthritis. Arthritis Rheum (Arthrit Care Res). 2006;55:294–9.CrossRefGoogle Scholar
  14. 14.
    de Croon EM, Sluiter JK, Nijssen TF, Dijkmans BAC, Lankhorst GJ, Frings-Dresen MHW. Predictive factors of work disability in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis. 2004;63:1362–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Cheeseman Day J, Janus A, Davis J. Computer and internet use in the United States: 2003. Washington, DC: US Department of Commerce; 2005.Google Scholar
  16. 16.
    Bureau of Labor Statistics. Computer and internet use at work in 2003. Washington, DC: United States Department of Labor; 2005.Google Scholar
  17. 17.
    Kuo PL, Lee DL, Jindrich DL, Dennerlein J. Finger joint coordination during tapping. J Biomech. 2006;39:2934–42.CrossRefPubMedGoogle Scholar
  18. 18.
    Sangole AP, Levin MF. Arches of the hand in reach and grasp. J Biomech. 2008;41:829–37.CrossRefPubMedGoogle Scholar
  19. 19.
    Rose MJ. Keyboard operating posture and actuation force: implications for muscle over-use. Appl Ergon. 1991;22:198–203.CrossRefPubMedGoogle Scholar
  20. 20.
    Baker NA, Cham R, Cidboy E, Cook J, Redfern M. Kinematics of the fingers and hands during computer keyboard use. Clin Biomech. 2007;22:34–43.CrossRefGoogle Scholar
  21. 21.
    Pascarelli EF, Kella JJ. Soft-tissue injuries related to use of the computer keyboard. J Occup Med. 1993;35:522–32.CrossRefPubMedGoogle Scholar
  22. 22.
    Biese J. Arthritis. In: Cooper C, editor. Fundamentals of hand therapy. St. Louis, MO: Mosby, Inc.; 2007. p. 348–75.Google Scholar
  23. 23.
    Baker NA, Redfern M. Potentially problematic postures during work site keyboard use. Am J Occup Ther. 2009;53:386–97.Google Scholar
  24. 24.
    Baker NA, Redfern M. The association between computer typing style and typing speed. Proceedings of the human factors and ergonomics society 51st annual meeting; 2007: human factors and ergonomics society. 2007; p. 869–73.Google Scholar
  25. 25.
    Baker NA, Redfern M. Developing an observational instrument to evaluate personal computer keyboarding style. Appl Ergon. 2005;36:345–54.CrossRefPubMedGoogle Scholar
  26. 26.
    Baker NA, Cook J, Redfern M. Rater reliability and criterion validity of the keyboard personal computer style instrument (K-PeCS). Appl Ergon. 2009;40:136–44.CrossRefPubMedGoogle Scholar
  27. 27.
    Salthouse TA. Effects of age and skill in typing. J Exp Psychol Gen. 1984;113:345–71.CrossRefPubMedGoogle Scholar
  28. 28.
    Dennerlein J, Kingman I, Visser B, van Dieen JH. The contribution of the wrist, elbow, and shoulder joints to single-finger tapping. J Biomech. 2007;40:3013–22.CrossRefPubMedGoogle Scholar
  29. 29.
    Harding DC, Brandt KD, Hillberry BM. Finger joint force minimization in pianists using optimization techniques. J Biomech. 1993;26:1403–12.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Nancy A. Baker
    • 1
  • Norman P. Gustafson
    • 1
  • Joan Rogers
    • 1
  1. 1.Department of Occupational TherapyUniversity of PittsburghPittsburghUSA

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