Lancaster Physician Fall 2020 - 28

L A N C A S T E R M E D I C A L S O C I E T Y.O R G

Healthy Communities

Unmounted adjustable height keyboard
supports, which rest on top of a desk or
table, are available online or in office supply
stores. To check it out with no financial
investment, you can try using a cardboard
box to elevate the keyboard and tilt the
angle of the monitor. Ideally, try to maintain
the 90-degree angle of elbow flexion in the
standing or sitting position.
Avoid dangling your feet off the edge of
the chair, which increases pressure on the
posterior thigh and sciatic nerve. A small
box or old phonebook can serve as a foot
support. For correct positioning, you should
be able to reach under the lower thighs above
the knees with your fingertips. The hips and
thighs should be parallel with the floor. Try
not to sit directly in front of drawers or
cabinets with no leg room.
Consider alternating mouse use with the
right and left hand (it takes practice!) by
moving the mouse to the opposite side of
the keyboard. Another option is to place the
mouse on a clipboard or other flat surface on
your lap while sitting. Place frequently used
items close to your body. Stand up to reach
items that cannot be reached comfortably
from a sitting position.
Once your hands and upper body are in
good position, we turn our attention to the
video monitor. It is important to adjust the
height of the monitor so that you can look
straight ahead at the monitor without flexing
or extending the neck more than 15 degrees
from the neutral position. Excessive neck
flexion or extension may increase headaches
by putting tension on the occipital nerve or
cervical paraspinal and trapezius muscles.
If the monitor height is not adjustable, try
raising the monitor to the correct height by
placing it on top of one or two large books
that fully support the base of the monitor.
Some jobs require two monitors. Center
the main screen in front, with the other
monitor angled at the side with the edges
touching (no gap in between). If you use
both monitors equally, they both should
be angled in a "V" shape in front of you.

To relieve eyestrain related to use of
accommodating eye muscles for an extended time, increase the distance to the focal
point by moving the video screen further
away. With a laptop screen, take 30-second
breaks where you focus out of a window at
a distant point every 30 minutes. If your
home office does not have a window, look
down a long hallway or hang a picture of
an outdoor scene on the opposite wall. If
you are using a telephone handset instead
of your computer's microphone for frequent
conference calls, consider getting an earpiece
with a microphone, so you can avoid bending
your neck laterally, which applies pressure
on the cervical facet joints. It is best to keep
any bright light, such as a reading lamp, to
the side of the monitor.
Studies of office workers have shown
health benefits from alternating sitting and
standing while working. Prolonged sitting
correlates with discomfort in the back and
thighs. Cognitive functions, including creative problem-solving skills, diminish with
sitting for only two hours. Consider standing
when making audio-only telephone calls.
Some remote workers are extending their
workday into evening hours. Distractions
in the home environment can make it
difficult to complete work during standard
business hours. Consider powering-off your
electronics after business hours, unless you
have a project that cannot wait until the
next business day. Remember that cognitive
work in the evening will activate excitatory
neurotransmitters in the cerebral cortex and
may disrupt sleep. Try to create down time
of at least 60 minutes prior to bedtime to
allow for the best restorative sleep.

LANCASTER

28

PHYSICIAN

FOR FURTHER
READING:
Mayo Clinic provides a good
collection of videos for
stretching exercises you can do
in your office at home or at work.
https://www.mayoclinic.org/
healthy-lifestyle/adult-health/
in-depth/office-stretches/
art-20046041
The National Institute of
Occupational Safety and Health
(part of the Centers for Disease
Control and Prevention) has
resources devoted to ergonomics
for office workers and health care
workers, as well as other work
settings.
https://www.cdc.gov/niosh/
topics/ergonomics/default.html
The short-term musculoskeletal
and cognitive effects of
prolonged sitting during office
computer work are explained
in the International Journal
of Environmental Research
in Public Health. 2018 Aug
7;15(8):1678. Free full-length text
is available at https://pubmed.
ncbi.nlm.nih.gov/30087262/


https://www.mayoclinic.org/ https://www.cdc.gov/niosh/ https://pubmed http://ncbi.nlm.nih.gov/30087262/

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