- The Washington Times - Monday, July 24, 2006

Physical therapist John Kuhn starts with the chair when he evaluates ergonomics for an employee of Inova Health Systems in Fairfax.

In the case of Anne Maddox, a risk manager for Inova, her chair was positioned correctly and only needed to have a separate lumbar support moved up two inches, says Mr. Kuhn, senior physical therapist assistant and industrial rehabilitation specialist for the Inova Physical Therapy Center in Ashburn, Va.

The objective for correcting ergonomics is to help prevent fatigue and injury and enhance employee productivity, Mr. Kuhn says.

He visited Ms. Maddox at Fair Oaks Medical Plaza earlier this month after she had complained of shoulder and arm pain. He told her that her feet should be flat on the floor, her knees just below her hips, and her wrists in a neutral position without bending upward or downward. To achieve this positioning, he moved her computer from the left side of her desk to directly in front of her so the monitor was at eye level, and he moved the mouse and keyboard with wrist guard closer to the desk edge.

Ms. Maddox says the changes “will keep me from straining my neck to the left side as I do computer [work] and paperwork at the same time.”

“You want to design the workplace around the worker,” Mr. Kuhn says. “You want anything they use frequently to be accessible to them.”

Ergonomics is the correct use of body posture to prevent musculoskeletal injury not only at work, but during any activity of daily living, says LaVerne Tuckson, coordinator of the Physical Therapist Assistant Program at the Takoma Park/Silver Spring campus of Montgomery College.

Poor posture causes some muscles to be elongated and weakened and the opposing muscles to become shortened, with poor blood flow, Ms. Tuckson says.

“The indication of that is pain,” she adds.

Pain can occur in the upper and lower back, neck, shoulders, arms, wrists and other parts of the body from injuries in the muscles, joints, nerves, tendons and ligaments. Doing repetitive tasks, working in one position and enduring loads and forces on the body can cause pain and injury.

Ignoring ergonomics also can be harmful if many hours are spent working in front of a computer, says Rani Lueder, president of Humanics ErgoSystems Inc., an ergonomics consulting firm in Encino, Calif., and member of the Human Factors and Ergonomics Society.

More and more people use computers at work, increasing from an hour or two a day in the mid-1980s to as many as eight hours, plus overtime, Ms. Lueder says.

“We could sit in chairs that were improperly adjusted in the 1980s and it didn’t matter,” she says.

The word ergonomics derives from the Greek “ergon,” or work, and “nomos,” or laws, or the science of work.

“It’s the study of making the work area fit the body so the body doesn’t have to work out of its comfort zone,” says Wendy Young, president of Ergopro, a Bellaire, Texas-based provider of ergonomics training, consulting services and ergonomics products.

The comfort zone is the area around the body that doesn’t require reaching or leaning forward, bending backward, twisting to the side or overextending, Ms. Young says.

Physical therapist Gad Alon recommends frequently changing positions while working at a desk to prevent loading (putting weight and stress) on any one area of the body.

“The principle is well-known in biomechanics that a static situation is not good,” says Mr. Alon, associate professor of physical therapy and rehabilitation science at the University of Maryland School of Medicine in Baltimore. He holds a doctorate in biomechanics and kinesiology, the science of movement analysis. “Our body is designed to be moving,” he says.

Ms. Lauder recommends standing up and doing stretching exercises while at the desk and taking rest breaks, preferably several in a day instead of one long break.

“The idea of rest breaks is to prevent things from happening and to provide recovery time so you don’t become injured,” Ms. Lauder says.

Paying attention to ergonomics makes good business sense, says Kaleel Ahmed, business unit manager for the work-space solutions unit of 3M in St. Paul, Minn.

“Comfort is one of the keys to being productive,” Mr. Ahmed says. “Ergonomics is about finding your most comfortable position.”

Finding a comfortable position when using a laptop, however, can be more difficult because the keyboard is connected to the screen. Hewlett Packard places a label on its laptops sending customers to a Web site for ergonomics information.

“It educates people on neutral postures to maximize comfort and productivity,” says John Gargiulo, HP global program manager for ergonomics and industrial hygiene in Roseville, Calif.

HP advises customers to use external attachments, including a keyboard, mouse and notebook or laptop stand, if they plan to use the laptop for more than one or two hours at a time, Mr. Gargiulo says.

“There is no perfect posture we can stick you in that you’re going to be comfortable in for eight hours,” he says. “We’re trying to avoid static postures that are non-neutral.”

The same checklist for proper ergonomics for computer and laptop use can be applied to driving, says Anne Kramer, chief executive officer of Ergo Works Inc., a full-service ergonomics company in Palo Alto, Calif.

Mrs. Kramer recommends adjusting the seat so one foot is on the floor, and he says the driver’s arms should be relaxed at his or her sides when the hands are holding the steering wheel.

The knees also should be bent at 40 degrees to 45 degrees and a lumbar support used to support the back, especially for long distances, says Dr. Janaki Kalyanam, chairwoman of the Department of Physical Medicine and Rehabilitation at Howard University Hospital in Northwest.

“The knee is flexed so pressure doesn’t occur by holding the knee in place,” Dr. Kalyanam says.

However, most ergonomics-related pain and injuries from driving are in the lower back and pelvis, Mr. Alon says, adding that car seats typically have a poor ergonomic design, allowing the driver to sink into the seat, putting pressure on the lumbar area.

“The key is to be mobile and not to stay in any given position more than you have to,” he says.

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