Web Posted on: February 24, 1998

EVALUATING THE EFFECTIVENESS OF ALTERNATIVE KEYBOARDS AS AN ACCOMMODATION FOR CTDs

Beth A. Loy, MS and Linda C. Batiste,MS
Job Accommodation Network
West Virginia University PO Box 6080
Morgantown, WV 26506-6080
800-ADA-WORK

As the computer continues to be the tool workers use to complete job tasks in a faster, more efficient way, typing is becoming an essential job function in a wider variety of jobs. With more typing has come an increase in reported cases of cumulative trauma disorders (CTDs) associated with keyboarding. These disorders have been shown to result from the repetitive or sustained micro-trauma occurring from prolonged keyboarding.

As a result of the increase in CTDs, US businesses have paid billions in direct workers' compensation benefits for conditions such as carpal tunnel syndrome and tendonitis. This rise in the frequency of CTDs, has spawned various responses: California adopted an ergonomics regulation; the Occupational Safety and Health Administration proposed an industry-wide ergonomic standard; and the Equal Employment Opportunity Commission has witnessed a rise in complaints filed under the American's with Disabilities Act by individuals seeking job accommodations related to their reported CTD.

An accommodation information service, the Job Accommodation Network (JAN), was created in 1983 to provide employers with timely and accurate information related to job accommodation options. With the rise in CTDs, JAN has experienced increasing numbers of requests for information related to accommodations for individuals with a CTD, particularly those who have keyboarding as an essential function of their job. Between January 1, 1992, and December 1, 1996, JAN received 117,300 calls, 1,076 of which involved a reported CTD and the job task of keyboarding.

In an attempt to accommodate these individuals, researchers have designed several alternative keyboards. Their goal has been to design a layout that helps reduce and/or eliminate the occurrence of CTDs resulting from keyboard use. Research has shown there are questions as to whether an alternative keyboard is an effective accommodation. JAN consultants recently designed a study to help answer some of these questions.

A telephone survey, asking a sample of the 1,076 callers requesting accommodation information related to the use of an alternative keyboard as an accommodation for a CTD and keyboarding, was completed. The objectives of the study were to provide survey results indicating:

• The prevalence of alternative keyboards being considered and/or used as an accommodation for CTDS among JAN callers;
• The effectiveness of alternative keyboards as an accommodation for CTDs;
• The perceived benefits or drawbacks of an alternative keyboard on keyboarding performance; and
• Recommendations on improvements for alternative keyboards.

The study returned a sample of 70 survey participants out of the total 1,076 callers, amounting to a survey return rate of 6.5%. Most (63%) of the sample reported carpal tunnel syndrome as the specific type of CTD callers were interested in accommodating. Twenty-nine percent of JAN callers were asking for accommodation information on behalf of the employer; 27% of callers were rehabilitation professionals calling to accommodate a client; and 20% of callers were seeking ideas on how to accommodate themselves.

Participants were asked about characteristics of the person with a CTD. Eighty-nine percent were females and the average age of the person with the CTD was 40 years old. Eighty-seven percent of these were considered touch typists, those who can do effective typing without looking at the keys versus using the hunt and peck method, where individuals look at a key as it is needed. The individuals requesting accommodations reported an average of 6 hours of keyboarding per workday and an average of 0.5 hours of keyboarding at home.

Thirty-six percent of those surveyed stated that an alternative keyboard was used to accommodate the person with a CTD. When an alternative keyboard was chosen as an accommodation, the Microsoft Natural Keyboard was the one chosen most often. The highest percentage of callers, 28%, indicated this was due to cost. Eighty percent of those who chose an alternative keyboard found it to be effective, rating it as a 4 (with 5 being completely effective) for effectiveness in reducing or eliminating the effects of a CTD. Seventy-four percent said their alternative keyboard relieved their symptoms but felt it could be more effective with additional wrist rest room, a lighter touch, a change in tilt angle, training, and combining it with voice input software and/or foot controls. Fifty percent of the users believed the alternative keyboard's best attribute was its split design while 25% felt this was the alternative keyboard's worst attribute.

Of those using an alternative keyboard, the average length of use was 1.5 years and most (36%) were recommended by a doctor. Of those instances where an alternative keyboard was not used as an accommodation, 44% had considered the use of an alternative keyboard but did not purchase one. Most (24%) said other changes (the use of a voice input system or making workstation adjustments) were made without the consideration of an alternative keyboard as an accommodation. If an alternative keyboard was considered as an accommodation, why wasn't one chosen? Most (38%) again, said other changes were necessary.

In summary, limited research has been targeted towards the effects of alternative keyboard use on the reduction or prevention of CTDs. Even though this research shows there may be benefits to using an alternative keyboard, it does not indicate that an alternative keyboard will eliminate a CTD. Neither do the data show that an alternative keyboard helps to prevent CTDs.

It is our conclusion, therefore, that an alternative keyboard should not be looked upon as a "cure all." The decision to use an alternative keyboard should not be considered without also addressing the effects that other factors, such as repetition and force, have on the user. These data do show, however, alternative keyboards may reduce some of the discomfort and other symptoms related to a CTD.