Healthy Computing:
A Comprehensive Group Training Approach Using Biofeedback


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



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



2.1. 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.



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.



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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