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Best Input Technology for People who have Carpal Tunnel Syndrome

Posted on 2012-03-21
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Last Modified: 2012-03-24
Hello,

A year ago my wife's office adopted a electronic medical records system.  This system requires that everything be entered in the computer.  She literally spends 3+ hours a day using a mouse to click in and out of different screens.  Before this system she rarely used a computer.

She has been diagnosed with severe Carpal Tunnel Syndrome.  Some nights she comes home and her hands and wrists are numb with pain.  I am looking for suggestions on something she can use instead of a mouse to navigate the EMR system.  She has tried using a trackball, but did not like that.  Is there some form of laser pointer, or other device, that is proven effective for people with severe CTS?  Let me know if you have any questions.

Thanks!

P.S. In terms of cost, we would be willing to spend hundreds of dollars on a solution  if it truly solved this problem.
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Question by:MrChip2
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by:dbrunton
dbrunton earned 200 total points
ID: 37749546
Seriously consider a change in job career with those symptoms.

If that isn't practical then she needs to perform hand and arm exercises to relieve the stress.

See http://www.ccohs.ca/oshanswers/ergonomics/office/stretching.html as an example and search for more articles and books that cover exercises for the hands, fingers, arms and shoulders.  Very important she does that.

She needs to take breaks every 5 minutes from the computer and find other tasks to do that do not involve continouse data entry.

For data entry purposes look at Dragon Dictate http://www.nuance.com/dragon/index.htm from Nuance.  Number of packages they offer.  Note that dication is only 95%  or so accurate, needs training.  She would probably need a headset and microphone to stop annoying other workers in her vicinity.

Learn keyboard shortcuts.  For example the Tab key to jump from field to field in data entry forms (Shift-Tab as well) and the use of ALT-Tab to switch Windows.  There are other shortcut keys.  Note that use of these will make her more productive BUT can still lead to more stress in her hands and fingers.  However they will keep her fingers and hands off the mouse.  I suspect the stress she is getting is from keyboard operation and not the use of the mouse.
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by:DaFranker
DaFranker earned 250 total points
ID: 37749579
If these symptoms happen in both wrists/hands in similar intensity, then it's extremely likely that as dbrunton said the stress and damage comes from keyboard use and typing. Here, hand exercises and good posture and ergonomic setup can help, but that's about it.

If you're sure it's the mouse, some people claim that a wacom tablet removes the problem with no loss in productivity. Keyboard shortcuts are also a lifesaver for mouse-specific issues where typing motion is already confirmed to not cause problems (which is frequent enough for people who had the forethought of configuring their workspace in a very ergonomic fashion with long sessions of continuous typing in mind).
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by:MrChip2
ID: 37749655
Thank you both for replying.  You both make great suggestions - I just don't think they will work for my wife.  Let me explain why.   Changing careers is not really an option - she is a physician and this is the new way that doctors work.  They already have Dragon installed for Health Care Professionals so she dictates most of her charts (sorry should have mentioned this).  She has also seen a number of specialists and is 99% sure it has to do with moving and clicking the mouse.  Her clinic uses a custom designed software app to manage medical records - I am not sure if it has any keyboard shortcuts (I will look into this though).  The system was designed so for every patient you need to use the mouse to drill down a number of levels for each individual malady.  So if an elderly patient comes in for a physical and has a history of heart problems, weight management, and something else - you have separate parts of the program to enter information for each issue.  For most people she spends a ton of time getting everything into his/her chart.  Oh, I should mention she has had several ergonomic specialists come in her office to select a custom chair and keyboard setup designed for her stature.

For now, I want to focus on something to replace the mouse.  After I posted the question I did some more research.  What do you think of foot pedals or touchpads?

Here is a link to a footpad.  Have you heard if these are any good?

http://www.askergoworks.com/products/1547/Foot-Mouse-with-Programmable-Pedal-FT07-02FT07-01-.aspx

What about a touchpad?  I found the following as one option:

http://www.askergoworks.com/products/476/Cirque-Smart-Cat-Touchpad-PD019SMC.aspx

I think if we could find a high quality wireless touchpad that let he stand up and enter the information, that would be ideal.  My Google searches keep pointing me to links for the HP TouchPad.  Thanks for your continued help. :)
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dbrunton earned 200 total points
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Can't comment on foot pedals.

Touch pad might be interesting or you might want to consider a touch screen or a touch screen overlay.  For example http://www.touchscreens.com/

Also consider an arm rest/pad to hold her arms up.  See http://www.fellowes.com/us/en/Products/Pages/product-details.aspx?prod=US-9175101&cat=WORKSPACE_ERGO&subcat=WRISTS_SUPPORT_WORKSPACE_ERGO&tercat=MOUSE_WRIST_SUPPORT_ERGO for an example.
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by:MrChip2
ID: 37749922
dbrunton,

The touchscreen overlay sounds very interesting.  Have you ever actually used one?  I wonder how the overlays compare to an actual touchscreen.
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by:DaFranker
DaFranker earned 250 total points
ID: 37749942
What I heard about footpads/foot-pedals suggests they merely "alleviate" carpal tunnel by relocating the problem, which means prolonged use of one would create equivalent issues in the ankles - not a "solution" in my opinion. However, this is merely hearsay: I know of no solid facts or studies confirming this, other than the obvious point that the foot has to make motions similar to the fingers when using one.

Touchpads or touchscreens seem to be worth trying and seriously considering.

There's one piece of tech that would solve this entirely, I guess, but unfortunately I've only seen prototype demos and I'm not aware of any publicly-available products like this. The tech basically merged a hacked Kinect rig with other sensors to track eye movements, and the point the eyes focused on became the position of the cursor, with light tongue clicks or tapping on something with a finger triggering "clicks". Just suggesting this as an additional avenue of research.
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Author Comment

by:MrChip2
ID: 37749967
DaFranker,

Thanks for the new idea.  I have not heard of it either - but it sounds like something to keep my eyes peeled for (no pun intended).

Do you have any experience with touchscreen monitors vs, overlays?  It looks like I can buy a 21" Touchscreen Monitor for $350 or so, and an overlay would cost about half that.  I wonder if a true touchscreen monitor would be noticeably better?
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by:DaFranker
DaFranker earned 250 total points
ID: 37750036
Although it's a bit old, here's a reference list of known eye-tracking devices and prototypes. Some of them seem to actually be available for sale right now on custom order, though I can't speak for their accuracy, reliability or pricing.

I'd recommend asking the manufacturers or resellers for a demo or to at least try the product before getting something blindly (no pun intended either), since equipment of this type for severely disabled people has a reputation of being too hard to configure and calibrate even for the head physician in charge of the intended patient!
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by:Callandor
Callandor earned 50 total points
ID: 37752202
It is very important to have the seat at the right height with respect to the desk when using a mouse for a long time.  The hands should extend straight out horizontally and there should be no lifting of the arms to get to the mouse.

She could try using the mouse with her left hand to let her right hand heal.  As long as it is aggravated, it won't get better.  Massage therapy can sometimes help relieve pressure on nerves.

There are Wacom input tablets that can substitute for a mouse - they use a stylus and are primarily intended for artists, so they are designed for people to use for long periods of time.
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