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In: Shumay, D. and Peper, E. (1997). Healthy Computing: A comprehensive group training
approach using biofeedback. In: Salvendy, G., Smith, M. J. and Koubek, R.J. (eds). Design
of Computing Systems: Cognitive Considerations. New York: Elsevier, 555-558.
Dianne M. Shumay and Erik Peper
Institute for Holistic Healing Studies, San Francisco State University,
1600 Holloway Avenue, CA 94132
1. BACKGROUND
Common interventions for preventing computer-related disorders (CRD)
tend to focus on ergonomics, while ignoring the role of other important risk factors.1
These other factors range from psychosocial stress to absence of somatic awareness,
and from physiological reactivity to workstyle.3-5 Previous research by Peper
and Shumay showed subjects can be trained to reduce arousal and muscle tension levels,
thereby reducing risk for computer related injury.6,7 Although individualized
training has demonstrated significant success, it is costly. Hence, group training may be
a cost effective educational method for preventing CRD and for redressing existing reports
of computer related discomfort, pain and injury. This study investigated the
psychophysiological and clinical efficacy of a group training program derived from the
individual multimodal biofeedback, somatic exercises and CRD prevention training protocol.8
2. METHOD
2.1. Subjects
Volunteer subjects were University employees (n=26; 8 male and
18 female; mean age=38.8; range: 25-54 years). All participants used a computer on the job
at least 4 days per week, and many reported at least some discomfort associated with
computer use.
2.2. Pre-/Post- assessment
Subjects were asked to complete an intake form and were seated in
front of an ergonomically-adjusted computer workstation.6,9 Surface EMG
(shoulder and forearm placements), respiration and temperature (index finger) were
recorded with sensors from the J&J I-330 physiodata system. Subjects performed a seven
minute typing task and filled out a subjective questionnaire regarding symptoms present
during the task.
2.3. Training sessions
Training was conducted by a trainer experienced in biofeedback
techniques, ergonomics and Healthy Computing practices. Participants attended 7 one-hour
sessions.
Assessment and training session -- After the pre-assessment,
results were shown to the trainee and specific training needs were discussed and homework
assigned based upon these results.
Ergonomic and worksite/workstyle assessment and training -- An
ergonomic assessment with recommendations was done at each subject's workstation.6
4 training sessions -- Sessions consisted of a mix of lecture,
practice, relaxation, movement exercise and discussion. Specific practices included:
biofeedback-modulated somatic awareness exercises and workstyle training; diaphragmatic
breathing; micro and macro breaks; cognitive and relaxation techniques for stress
management; stretching and strengthening exercises; techniques for reducing eyestrain;
weekly homework assignments to facilitate skill mastery and generalization; group
discussion and support for implementing changes.
Final assessment and training session -- After completing the
training sessions, Ss repeated the pre-assessment procedure. Trainees were then given
suggestions for further improvement and tips for continuing to implement changes.
2.4. One-year telephone follow-up
Seventeen subjects (2 men, 15 women; mean age=39.7, range 30-47) were
successfully contacted after the post baseline (mean = 13.7 months; range 9-20 months) by
an independent interviewer. Subjects described the usefulness of the program, change in
symptoms as compared to before the program and how much they use the specific skills.
3. RESULTS
Repeated measures one-way analysis of variance were used for all
analyses. We found significant decreases in all self-reported symptoms (F(29,
1200)=8.56; p<.001) (see fig. 1), in trapezius/scalene sEMG (F(1,
540)=16.20; p<.001) and in breathing rate (F(1, 540)=8.88; p<.003)
pre to post training (see fig. 2). We found a significant increase in hand temperature (F(1,
540) =11.84; p<.001) after the Healthy Computing program (see figure 2).
Upon one-year follow-up, 17 subjects reported that the program
was very useful (mean = 4) on a scale of 1 -- not at all, 3 -- somewhat, to
5 -- very useful; subjects’ symptoms decreased as compared to before the
program (mean = 1.3) on a scale of -2 -- worse, 0 -- same, to +2 -- better,
as shown in fig. 3; and they continued to use the techniques/skills they learned (mean =
3.5) on a scale of 1 -- not at all, 3 -- somewhat, to 5 -- all the time.
Subjects found the following techniques/skills the most beneficial: awareness and training
in muscle tension (44%); micro-breaks (37.5%); ergonomics (25%); relaxation skills (25%);
and breathing (19%).
 
Figure 1. Self-reported symptoms during 7 minute typing task -- pre- to
post-training.
 
Figure 2. Psychophysiological changes during 7 minute typing task --
pre- to post-training.
4. DISCUSSION
After going through the Healthy Computing training program,
participants showed a significant reduction in all symptoms during typing and had
significantly lower breathing rates, lower scalene/trapezius muscle tension levels, and
increased peripheral temperature during computer use than prior to the training. After a
year, participants were still using the skills they had learned in the training and
continued to report a decrease in symptoms as compared to before the program. Departments
that went through the training as a group found that the experience worked both as a
teambuilding exercise and also fostered support for practicing the techniques in their
offices. The Healthy Computing group training program appears to be a cost-effective
method for reducing the risk of CRD.
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