Date: Mon, 28 Mar 94 11:47:08 -0500 From: Steve Wartik **************************************************************** A REVIEW OF THE COMFORT KEYBOARD SYSTEM(TM) March 28, 1994 Steve Wartik Software Productivity Consortium 2214 Rock Hill Road Herndon, Virginia 22070 703/742-7176 wartik@software.org I have been using the Comfort Keyboard System, manufactured by Health Care Keyboard Company, for about one month. I believe this is long enough to develop an appreciation of its features and an estimation of its ability to relieve my repetitive stress injuries. The following describes my opinion of it. MY CASE HISTORY In the spring of 1993, I worked on a project that required me to spend long hours at my keyboard. I experienced some discomfort, but my pains would disappear by the time I ended my commute. Then suddenly, within a week, I realized that the pain was extending far into the evening. Clearly, it was time for me to see a doctor. I was diagnosed with bilateral epicondalytis -- tennis elbow in both arms, primarily in the left. My physician (a rheumatologist) prescribed elbow bands. Almost immediately the pain in my elbows diminished, and became controllable over a period of several months. My coworkers teased me that I looked like a Nazi, but I felt I was making progress. Unfortunately, my troubles did not end there. I had begun reading sci.med.occupational and the typing injuries FAQs, and I realized that my posture was horrible. This was due in part to my office furniture. My desk was much too high. Holding my arms in the recommended position, upper arms vertical and forearms horizontal, meant my feet would be far off the floor. In any case, I couldn't adjust my chair that high. Its unadjustable arms would bump against the bottom of my desk. I solved the height problem by getting a keyboard tray. However, the tray only accommodated my keyboard. My mouse had to remain on my desk, requiring awkward arm extensions. I asked for a separate mouse tray but was told that my desk could not handle the weight. No better desks were available, and ordering a new one would take time. I began developing severe pains in my left shoulder and lesser ones in my right shoulder. I think this was because I had become accustomed to resting my arms on my desk as I typed. When I switched to the keyboard tray, my shoulders took up the stress. My muscles weren't prepared for that strain. This was around the beginning of November, 1993. About then I began seriously investigating alternative keyboards. In December of 1993 a representative from a local company that markets the Comfort Keyboard System, along with a representative from Health Care Keyboard Company, visited my company, presenting their product and how to use it. In March of 1994, I obtained a demonstration model of the Comfort Keyboard System, to be used and evaluated for one month. THE COMFORT KEYBOARD SYSTEM The Comfort Keyboard System is described well in the FAQ on alternative keyboards. The concept is simple: take an IBM-style keyboard, split it into 3 parts (QWERT side, YUIOP side, and numeric keypad), and place each part on an incredibly adjustable base that can tilt to almost any angle and swivel in any direction. Allow the 3 parts to be positioned in any order. Add some handy programmable features (macros) to save on keystrokes. Throw in some arm rests and a few other niceties, like a rest period reminder. If this doesn't make sense, look at the picture in the soda.berkeley.edu archives. One picture shows it much better than I can say it. It's an ingenious concept. Does it actually help with repetitive stress injuries? USING THE KEYBOARD The manual that comes with the keyboard recommends that you start with the sections more or less flat, and slowly tilt them to less standard orientations. They seem to imply that you will ultimately want to sections raised to significant angles, although they also state that you should find what's right for you. I started with the keys flat, but spread to reduce ulnar deviation. I quickly found that, for me, the best way to achieve this was to put the numeric keypad in the middle. (I tried it in all 3 positions; my thoughts on this matter are described below.) I began tilting the keys towards vertical. I think I progressed far too quickly! My fingers were not used to typing in that position. I began feeling numbness in my hands (some of which might be attributable to the arm rests -- see below) and returned the keys to an almost-flat but spread-apart configuration. They're tilted at perhaps 15 degrees from horizontal, and swiveled about that much towards me. ADVANTAGES The Comfort Keyboard System's product literature promises adjustability. It certainly delivers on that. My personal preference is to have the QWERT and YUIOP sections on either end, with the numeric keypad in the middle. Also, I've got the sections angled just slightly -- and not symmetrically, either. This position, for me, eliminates ulnar deviation completely. I quickly grew used to the position. After only a few days, my hands felt cramped when I used a regular keyboard. The layout is immediately familiar to PC users. Unfortunately, I don't happen to be one (I had an Apollo), so I keep hitting the wrong keys. But that's my failing. Clearly, Health Care Keyboard Company has gone after conformance with the largest market segment. There's another advantage to the PC as a basis: the keyboards have ALT and CTRL keys on both sides. You don't need to stretch your fingers to invoke all those special functions. This detail spared me a lot of pain. The rest period indicator is a big help. It blinks an LED whenever you should take a break. (I might even add a bell; sometimes I'm so absorbed in my work that I don't notice the LED, and it's right below my monitor.) By default, it notifies you every hour. You can easily program it to notify you at intervals between 10 minutes and 2 hours. The 3 parts of the keyboard are easily tilted and swiveled, although sometimes you'll wish for 3 hands as you try to hold them steady while you tighten the locking mechanism. Interchanging them isn't quite so easy, but is simpler with practice. Anyway, you won't want to interchange them very often after you find a set-up that suits you. Once set up, they're sufficiently stable in all positions I tried. You do notice flexing when the sections are tilted, but it's not enough to be disturbing. The instruction book is clear and easy to follow. It goes into a lot of detail on how to choose a position that's right for you. I had no difficulty following the directions on how to program it (with one exception, noted below). DISADVANTAGES Before I go into the disadvantages, let me mention that my furniture still isn't ideal. I eventually obtained a surface that is both low enough to let my arms rest properly and wide enough to accommodate both my keyboard and my mouse. However, as I'll discuss below, I think I might need to do even more to show the Comfort Keyboard System at its best. The Comfort Keyboard System comes with arm rests. These have two problems. First, I found them too high. Health Care Keyboard Company recommends that you position the arm rests such that your arms rest on them about 4 to 6 inches from the keyboard. That means your keyboard has to be about 10 inches from the front of your desk. You've got to tuck your body under your desk, but -- if you want your forearms parallel with the floor -- you've also got to raise yourself up quite a bit. I couldn't fit myself. The arm rests forced me to hunch my shoulders. (The instructions show pictures of people whose upper arms seem extended much more than is desirable.) They also made my hands feel cold, and brought on pain in my wrists. Overall, I found they were exacerbating my pain, and relieving shoulder discomfort only slightly. My second problem with the arm rests was difficulty moving my arms to use my mouse, which I do quite a bit in my work. Lifting my arm off the rests and over to the mouse was awkward. Anyway, I didn't want to stop using the rest -- I wanted support as much as ever when using the mouse. But the arm rests weren't wide enough, any anyway you can't slide your arm around on them enough to use a mouse. I bought a trackball, and that helped: I could reposition the arm rest and use the trackball. This wasn't particularly convenient when I needed to switch back and forth, though. Eventually I abandoned the arm rests. I purchased some arm supports that attach to my desk and extend out on a system that allows my arms to swivel freely in a horizontal plane. (These have helped me considerably.) The keyboard itself strikes me as too tall. The mechanisms that allow all that flexibility make the 3 parts stand higher than a normal keyboard, even at their lowest. In my preferred orientation, the lowest key is a little over 2 inches above my desk. No matter what orientation I try, I can't both keep my forearms parallel to the floor and my wrists straight. I experience either wrist extension (when the keys are flat) or radial deviation (when the keys are angled vertically). I could solve this with other furniture, perhaps. Using the IBM keyboard as a model has a drawback. Pressing a function or ESC key requires moving your hand and arm. That's a problem for me with my weak and injured shoulders. Placing them right above the upper key row would have eliminated some of this motion. The numeric keypad can fit to the left of the QWERT section. Being a lefty, I figured this would be convenient. It didn't work. The tilting mechanism on the numeric keypad is designed for right-handed people. The numeric keypad can tilt 90 degrees clockwise, but only about 45 degrees counterclockwise. Perhaps Health Care Keyboard Company could be convinced to produce left and right-handed models. I did try putting the keypad on the right and tilting it. That wasn't convenient: with my hand on the YUIOP section, I had to move my hand around the numeric keypad to reach it. I think the concept works best if you're doing data entry, since you'll have your hand on the numeric keypad for a long period of time. I was using a text editor and only wanted to press the arrow keys occasionally, keeping my hand on the YUIOP section most of the time. I quickly learned that using control keys was easier. Mouse users beware. If you have the numeric keypad to the right of the YUIOP part, and if you tilt your numeric keypad, you've got an obstacle when you try to get to your mouse. I wish the Comfort Keyboard System had a built-in trackball. TRANSIENT PROBLEMS I found some other flaws that I think are attributable to the fact that the Comfort Keyboard System is still a new product. Indeed, they're almost all software-related! Their marketing department is over-eager. The product literature I received in December of 1993 says the Comfort Keyboard System works with PC's, Macintoshes, and Suns. The sales representative assured us we could use it with our NCD X terminals. It's now March of 1994, and a release for Suns is still planned. And the keyboard doesn't work with our X terminals either, the information in the FAQs to the contrary notwithstanding. The rest period indicator is inaccurate. Following the instructions, I programmed it for 30 minute intervals, with a 2 minute rest. The delay was closer to 40 minutes, and the rest period lasted about 2 minutes and 45 seconds. You can program the keyboard to do all sorts of fancy things (macros and the rest period length, for instance). You can save and restore settings using some software the company provides. Unfortunately, the software doesn't work. The error messages I received seemed to indicate that a byte was being lost somewhere or other. It happened several times, so I'm reasonably certain it's not our company's network. CONCLUSIONS Overall, I feel I've given the keyboard a fair trial. Not ideal, as should be apparent, but fair. I can't expect my company to drop everything and spend its time finding me the perfect office environment, and you can't either. What I've put together is probably typical of the best that most companies could do for the modern worker in a short period of time. So, in that short period, how do I feel? Here's a summary. I think the biggest lesson I have learned from using the Comfort Keyboard System is that you need a comprehensive solution to treating a repetitive stress injury. Don't think your problems will vanish just by getting this or any other keyboard. You need to consider your whole working environment. The Comfort Keyboard System is quite different from your regular keyboard. In particular, its height may require you to reconsider your furniture. I very much like eliminating ulnar deviation. I find the new shoulder and arm position much more comfortable. However, I don't like the wrist extension it forces on me. I find the keyboard intelligently designed, and put together well. Because of its height problems, I don't think it's the right keyboard for my injuries. Everyone agrees that the standard keyboard is a terrible design. Simply breaking it in parts may not be a sufficiently radical departure, no matter how you position the parts. This point aside, the Comfort Keyboard System certainly has the potential to reduce or eliminate some undesirable postures. As a final note, let me add that I did not consult with any representatives from Health Care Keyboard Company since obtaining the keyboard, nor have I had an occupational therapist evaluate my environment. My opinions derive from my own attempts to determine a comfortable position, based on reading the manual supplied by Health Care Keyboard Company and on reading the typing FAQs and other literature. I think this is representative of what you might experience if you purchased the Comfort Keyboard System, but you (and I) might do better to consult professionals as well.