Apparatus and method for reducing repetitive strain injuries

An apparatus and method for reducing, preventing, lessening and treating the incidence and severity of Repetitive Strain Injuries ("RSI") comprising a combination of computer software and hardware that provides a "prompt" and system whereby the computer operator exercises their upper extremities during data entry and word processing thereby maximizing the excursion (range of motion) of the joints involved directly and indirectly in computer operation. In summary, the apparatus and method of the present invention includes 1) specialized target means with optional counters which serves as "goals" or marks towards which the hands of the typist are directed during prolonged key entry, 2) software that directs the movement of the limbs to and from the keyboard, and 3) software that individualizes the frequency and intensity of the exercise sequence.

BACKGROUND OF THE INVENTION 
1. Field of the Invention 
This invention relates to repetitive strain injuries and, more 
particularly, to a method and apparatus for lessening the incidence and 
severity of repetitive strain injuries for those who frequently utilize a 
computer keyboard and mouse. 
2. Description of the Background Art 
Repetitive Strain Injuries (hereinafter "RSI") is an umbrella term which 
refers to strain injuries of the neuromusculoskeletal system. This 
syndrome may also be referred to as cumulative trauma disorder, repetitive 
use injuries, repetitive motion injuries, repetitive movement injuries or 
occupation overuse syndrome. RSI presumably result from fine fast 
repetitive activities which adversely affect the hands, wrists, forearms, 
elbows, arms and shoulders of one or both upper extremities. For instance, 
it is believed that repeatedly twisting and turning the wrist and 
pronating and supinating the forearm may result in this type of injury. 
While the exact nature or cause of this syndrome is not known, repeated 
keystrokes, long periods using peripheral computer devices such as mice, 
trackballs etc. are felt to damage the soft tissues of the extremities. In 
short, any activity that puts repeated or prolonged strain on the hands 
and wrists is thought to be cumulative and harmful. Static holding or fine 
hand tracking is also harmful. 
Carpal tunnel syndrome or compression/injury of the median nerve in the 
wrist carpus! is the most publicized RSI but not the only one. 
Tendinitis, tenosynovitis, capsulitis, myositis, neuritis, bursitis and 
epicondylitis are other related terms used interchangeably with the 
condition. In the past RSI has been frequently seen in musicians, 
scanners, splicers, meat cutters, sheep shearers and in other trades which 
employ fine repetitive movements of the hands for long periods. However, 
the explosion of the "information age", with the attendant increase in 
keying and data entry, has focused many health problems on the computer 
workstation. 
The incidence of RSI is believed to increase when a computer operator 
(i.e., a secretary or data entry personnel) repeats the same movement 
countless times a day. For instance, if during typing a computer operator 
keys an average of five (5) keystrokes per word.times.60 words per minute 
this equals approximately 300 keystrokes per minute which on average 
equals roughly 18,000 keystrokes per hour. 
Major symptoms include pain anywhere in the limb, numbness and tingling in 
the hands, clumsiness, heaviness, loss of coordination and strength in the 
hands, night pain and numbness, and tightness and stiffness in the upper 
limb(s). Physical signs included tender muscles and joints, loss of 
sensibility, increased coolness and sweating, decreased strength, motion 
and dexterity. For the most part, there is an absence of gross and 
microscopic inflammatory findings and characteristically most of the signs 
and symptoms fail to improve with conventional treatments. RSI may 
temporally respond to rest, splints, exercises and changes in position but 
the syndrome often returns quickly with the resumption of activity. End 
stages of the condition may be associated with symptoms which fail to 
improve with rest. 
The cost associated with RSI in the workplace is significant. There is loss 
of productivity, compensated time out of work, bills for direct and 
indirect medical care, legal expenses for administering claims, expenses 
for employee retraining, increased indemnity and worker's compensation 
insurance. 
Continued efforts are being made to change computer keyboards, peripherals 
and methods to reduce RSI. Consider background patents which illustrate, 
for example, the large number of keyboard and "mouse" devices designed to 
reduce and lessen the incidence of RSI such as in U.S. Pat. No. 5,581,277 
to Tajiri; U.S. Pat. No. 5,567,067 to Amborse which teaches a keyboard 
positioning system; 
U.S. Pat. Nos. 5,161,760 and 5,398,896 to Terbrack teach keyboard forearm, 
wrist and hand support devices for use in conjunction with the keyboard of 
a computer which are designed to reduce stress on the user's shoulders, 
arms, wrists and hands. Using an external mouse or input device may remove 
at least one hand from the keyboard at a time, however, the fine status 
control required to manipulate these devices mimics the original injurious 
environment. 
In addition, "ergonomic" devices designed to decrease repetitive strain 
injuries are disclosed in a number of patents. By way of example, note 
U.S. Pat. No. 5,137,384 to Spencer et al.; U.S. Pat. No. 5,522,323 to 
Richard; and U.S. Pat. No. 5,311,210 to O'Brien et al. Furthermore, many 
large computer companies ship printed and/or on-line user guides which 
describe RSI symptoms and suggest alternatives including ergonomic 
changes. 
Another grouping of background patents are those which disclose treatment 
methods and apparatus for treating common RSI such as carpal tunnel 
syndrome. By way of example, note U.S. Pat. No. 5,551,933 to Washburn; 
U.S. Pat. Nos. 5,366,436 and 5,492,525 to Gibney; U.S. Pat. No. 5,441,058 
to Fareed; U.S. Pat. No. 5,413,553 to Downes; and U.S. Pat. No. 5,501,657 
to Feero. The patent to Feero teaches a method of alleviating carpal 
tunnel syndrome that is directed to a therapeutic manipulative method that 
in part reduces the inflammation and increases circulation about the 
flexor cavity. 
There is software currently available, which through use of sound or screen 
messages monitors key activity and reminds the computer operator to take a 
break or stop data entry. Some of these software programs even "suggest" 
and illustrate exercises that a computer operator should perform at their 
station. Additionally, there are programs and company policies which 
strongly urge or mandate that computer operators periodically exercise and 
stretch after a given duration (usually after a half or full hour of 
input). Additionally, these software programs usually impose a break based 
upon either entry time or work. However, tracking work/clock time is not 
constant and influenced by many factors (i.e. comfort adjustments and 
telephone breaks). Additionally, none of the available software is 
designed to be utilized in conjunction with a specialized target mounted 
to a computer monitor. 
There are many ergonomic devices available, and ergonomic consulting 
services which recommend flexing the wrists slightly with pads or slants 
which are affixed to or proximal to the keyboard, however, these devices 
rarely help because the computer operator continues to statically position 
their limbs. 
While these programs and policies may aid somewhat in lessening the 
likelihood of RSI they do not address the root of the problem, 
specifically, compelling the computer operator to regularly remove their 
hands from the keyboard and carry out a series of exercises designed and 
timed to alleviate and prevent RSI. 
Lastly, U.S. Pat. No. 4,807,642 to Brown teaches a monitoring device that 
detects muscle strain and triggers an acoustic signal to indicate when an 
undesirable strain condition exists. U.S. Pat. No. 5,538,431 to Dempter 
teaches typing and mouse manipulation techniques and the methods for 
teaching these techniques which are designed to avoid repetitive strain 
injuries. The techniques taught by this patent are very complex and 
require the typist to constantly monitor and self-adjust the positioning 
of their hands, wrists and arms. Specifically, the second step of this 
method is that the typist strikes individual selected keys using 
coordinated finger, hand, wrist and arm movements approximately in the 
midrange of joint articulation, including, as required to strike a 
selected key. The patent to Dempster names these "leap frog type hand and 
arm", "swinging arm" or "in and out hand and arm" movements. However, the 
techniques taught by this patent are complicated and would not only 
require a great deal of instruction but in all likelihood would be readily 
abandoned by an individual typist because they require a typist to relearn 
typing skills and essentially start from square one. Also, the efficiency 
of these patents is directed to joint position at key impact rather than 
mobilizing the joints to improve their biological environment. 
Efforts to improve the methods and apparatus to reduce RSI continue. The 
method and apparatus of the present invention is based upon the assumption 
that continuous and static hand and limb positioning at the computer 
terminal produces an unhealthy physiological environment for the upper 
anatomy. The apparatus and method of the present invention emphasizes the 
beneficial effects of active movement of human upper joints in conjunction 
with cessation of input activities. Specifically, the apparatus and method 
of the present invention prompts the computer operator to increase the 
mobility of their upper joints. Joint motion requires active muscle 
contraction. This physiologically mobilizes all para-articular soft 
tissues especially peripheral nerves which without such stimuli become 
static, abnormally sensitive and produce pain, numbness and 
hypersensitivity. These upper joint movements are needed continually and 
regularly during key input. Hourly breaks and daily exercise programs are 
far from ideal and are generally used as rest periods without proper 
active exercises. 
Accordingly, it is an object of the invention to provide an improvement 
that overcomes inadequacies of the prior art devices and provides an 
improvement, which is a significant contribution to the advancement of the 
art. 
Another object of the invention is to provide an apparatus and method to 
reduce the incidence of RSI in computer operators. 
A further object of the invention is to provide an apparatus and method to 
prevent RSI in computer operators. 
A further object of the invention is to provide an apparatus and method to 
lessen RSI in computer operators. 
A further object of the invention is to provide an apparatus and method to 
treat RSI in computer operators. 
A further object of the invention is to provide a new apparatus and method 
which direct the computer operator to exercise both upper extremities 
during data input. 
A further object of the invention is to provide and apparatus and method 
which prompts the computer user to physically remove their hands from the 
computer keyboard and execute a sequence of exercises designed to maximize 
the mobilization of the joints of the upper extremities. 
A further object of the invention is to provide a new apparatus and method 
which may be utilized in conjunction with already available commercial 
products and ergonomic adjustments. 
A further object of the invention is to provide an apparatus and method for 
reducing the incidence of RSI which does not greatly reduce employee 
productivity, require a great deal or training or deviate from known 
methods of data entry. 
A further object of the invention is to provide a method which can be 
readily modified to prevent, alleviate and improve RSI symptoms in all age 
groups. 
The foregoing has outlined some of the pertinent objets of the invention. 
These objects should be construed to merely be illustrative of some of the 
more prominent features and applications of the intended invention. Many 
other beneficial results can be attained by applying the disclosed 
invention in a different manner or modifying the invention within the 
scope of the disclosure. Accordingly, other objects and a fuller 
understanding of the invention and the detained description of the 
preferred embodiment in addition to the scope of the invention defined by 
the claims taken in conjunction with the accompanying drawings. 
SUMMARY OF THE INVENTION 
For the purposes of summarizing the invention, the invention comprises a 
combination of computer software and hardware that provides a "prompt" and 
system whereby the computer operator exercises their upper extremities 
during data entry and word processing thereby maximizing the excursion 
(range of motion) of the joints involved directly (i.e. wrists) and 
indirectly (i.e. shoulders) during computer operation. Specifically, the 
apparatus and method of the present invention is drawn to the prevention, 
lessening and treating of RSI in computer operators. 
For instance, computer entry people generally lock their upper limbs in 
static positions for long periods of time which may lead to or aggravate 
RSI. For purposes of discussion, it will be assumed that the operator is 
right-handed and will use a computer peripheral (i.e. mouse or trackball) 
which is positioned to the right of the keyboard. 
The focus of the apparatus and method of the present invention is to 
harmonize the movements of the shoulder, elbow, forearm and wrist joints 
during word processing and data entry. The forearm has two joints, one 
just below the elbow and the other at wrist level. Movement of the muscles 
at these joints creates a range of motion at these joints that until now 
have been ignored in discussions and treatments related to RSI. First, 
supination of the forearm rotates the palm upward (right palm clockwise) 
while pronation designates the opposite movement and rotates the palm to 
face and parallel the floor (right palm counter clockwise). Generally 
speaking, these movements are lessened by shoulder joint compensation. 
Additionally, during word processing and data entry, hand position and 
range of motion is controlled by the position of the wrist during keying 
or stroke input. Harmful static prolonged positioning does not impact the 
hands, thumbs or digits since they are always continually in motion during 
word processing or data input. 
As general background, and to aid in the understanding of the drawings, 
method and apparatus of the present invention, a brief discussion of the 
motion allowed by Synovial Joints (found at all articulations of the 
limbs) is provided. It must be born in mind that these are average range 
or arc of motion only, some individual's joints are more flexible while 
others are less so. Abduction occurs when the shoulder joint moves the 
limb away from the body midline while adduction is the movement towards 
the body midline. Extension is to straighten limbs at a joint while 
flexion is to bend limbs at the joint. Pronation occurs when the forearm 
is placed palm down and supination is to turn the forearm to place palm 
up. Internal rotation is to move the limb inward on a central axis while 
external rotation refers to the outward movement of the limb on a central 
axis. To fully understand the apparatus and method of the present 
invention, it is useful to classify and designate the upper extremity 
joints (i.e. shoulders, elbows, forearms and wrists) in three-dimensional 
space. 
Normal Joint Movement 
With the arms at the sides of the trunk, the shoulder abducts the arm away 
from the trunk of the body and adducts toward the midline of the truck. 
The range of motion is approximately 90.degree. from 0.degree. adduction 
to 90.degree. abduction. The shoulder extends forward in front of the 
trunk and flexes backward behind the trunk. This range of motion is 
approximately 150.degree.. With the arms at the sides of the trunk the 
shoulder internally rotates the arm (towards) and externally rotates the 
arm (away) from the midline. Internal and external rotation of the 
shoulders with arms abducted 90.degree. from the trunk, will not be 
discussed herein. 
The forearm rotates about an axis that runs longitudinally from the middle 
finger to the elbow. Full supination is noted by the palm being fully up 
and facing the ceiling. When the forearm is rotated and the palm faces the 
floor, full pronation has been achieved. The average total range of motion 
for the forearm is supination (80.degree.) to pronation (80.degree.) with 
a total arc of forearm rotation equal to 160.degree.. With the arms held 
at the trunk of the body, the shoulder rotates externally (45.degree.) and 
internally (45.degree.) for a total arc of motion of approximately 
90.degree.. 
The elbow flexes when the forearm closes the angle with the upper arm and 
extends when the angle decreases to zero (straight). The range of motion 
is 0.degree. (fully extended) to 110.degree. (fully flexed). 
The wrist extends when the back of the hand approaches the back of the 
forearms and flexes when the palm moves in the opposite direction. The 
average total range of motion for the wrist is 70.degree. extension and 
70.degree. flexion with a total arc of motion equal to 140.degree.. The 
wrist joint also deviates ulnarly towards the small finger and radially 
toward the thumb. The arc of motion (deviation) is roughly 45.degree.. The 
range of motion for this ulnar movement is much more extensive 
(30.degree.) than the radial movement (15.degree.). 
The shoulder is fixed in terms of abduction/adduction and forward/backward 
elevations. Rotary movements at the shoulders are minimal as computer 
operators often utilize deviation of the wrists to span the keyboard or 
manipulate the mouse. The elbow is almost always at the 90.degree. flexed 
static position. When the computer operator switches mode of input from 
the keyboard to the mouse, some external rotation of the arm at the 
shoulder occurs. Forearm rotational movement does not change significantly 
during computer entry operations and the wrists position tend to only 
change in a side-to-side (radial-ulnar) deviation. Even when the digits 
move rapidly to strike the keys there is little wrist flexion or extension 
observed. In summary, when utilizing "traditional" keying and typing 
techniques minimal movement occurs in the larger joints of the upper 
extremities during rapid keying. 
Restricted Joint Movement During Data Input 
Table 1. illustrates the rather limited joint movements involved in 
keyboard entry. 
TABLE 1 
______________________________________ 
ARC OF KEYING 
MOTION USE USE 
MOVEMENT (Deg) (Deg) (%) 
______________________________________ 
shoulder rotation 
90 15 17 
shoulder 90 20 22 
abduction/adduction 
shoulder 150 30 20 
extension/flexion 
elbow 110 25 23 
extension/flexion 
forearm rotation 
170 10 6 
wrist 140 35 25 
extension/flexion 
wrist radioulnar 
45 15 33 
deviation 
______________________________________ 
The arcs of motion data provided are averages only and will vary depending 
on an individual's musculature and muscular elasticity. Additionally, the 
data pertaining to the degree of motion of the joints during key entry are 
averages. Different postures, hand positions, chair and desk positioning 
and input techniques may increase a particular joint(s)' degree of motion 
but will conversely limit the range of motion in another joint(s). For 
example, if a keyboard is positioned below the level of the flexed elbow 
(90.degree.), the elbows will extend more and the wrists will flex much 
more and will not extend past neutral (0.degree.). 
On the most important considerations in the etiology of RSI is the negative 
effect of repetitive movement and static hand positioning on the 
micro-circulation of muscles, nerves, joint capsules and tendons. It is 
believed that the static holding and repeated contractions required in 
these activities, the tension (increased tissue pressure) produced and the 
electroactivity generated, impedes circulation into soft tissues and 
restricts the flow of nutrients to the system. Good circulation is also 
needed to rid waste products from the system. Active joints mobilize soft 
tissues and directly pump nutrients in and out and indirectly create 
differential gradients that enhance biological exchange. 
Theories regarding the adverse results of static hand positioning in 
keyboard activity is supported by the fact that "traditional" use of 
typewriters rarely produced this condition. Presumably, alternate 
movements such as carriage return and paper insertion required interrupted 
the cycle. Ergonomics also point to the beneficial effect of the upright 
keyboard on typewriters but this has not been supported by an equal 
improvement using one of the many keyboard modifications. Laptop users 
also don't usually experience symptoms as the data entry pool since laptop 
use is more for management and financial tasks which generally entail less 
static positioning of the hands and less continuous keying time. 
Therefore, in order to reduce the incidence of RSI it is necessary to 
provide an impetus for the computer operator to cease typing or data entry 
and deviate from the static position of the upper joints during computer 
word processing and data processing. Specifically, the present invention 
comprises an apparatus and method that provides a signal stimulus for the 
computer operator to remove their hands from the keyboard and carry out a 
series of exercises designed and timed to alleviate and prevent RSI. 
Furthermore, the apparatus and method of the present invention utilizes 
specially designed target means which are mounted to the computer monitor 
which aid in defining the trajectory of the computer operator's hands 
during the exercises. 
In summary, the apparatus and method of the present invention includes 1) 
specialized target means with optional counter means which serve as 
"goals" or marks towards which the hands of the typist are directed during 
prolonged key entry, 2) software that directs the movement of the limbs to 
and from the keyboard, and 3) software that individualizes the frequency 
and intensity of the exercise sequences. 
Advantageously, the apparatus and method of the present invention permits 
the alleviation and prevention of RSI without requiring extensive 
retraining of computer operators, nor significantly decreasing the 
productivity of computer operators. The foregoing has outlined rather 
broadly the more pertinent and important features of the present invention 
in order that the detailed description of the invention that follows may 
be better understood so that the present contribution to the art can be 
more fully appreciated. Additional features of the invention will be 
described hereinafter which form the subject of the claims of the 
invention. It should be appreciated by those skilled in the art that the 
conception and the specific embodiment disclosed may be readily utilized 
as a basis for modifying or designing other structures for carrying out 
the same purposes of the invention. It should also be realized by those 
skilled in the art that such equivalent constructions do not depart form 
the spirit and scope of the invention as set forth in the appended claims.

Similar reference characters refer to similar parts throughout the several 
view of the drawings. 
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
While it remains unclear exactly how the apparatus and method of the 
present invention performs, it is probable that the utilization of forced 
breaks with a programmed exercise program used in conjunction with a 
specially oriented target means increases joint movement, and mobilize 
tissues which improves local physiology thereby providing a means to 
prevent, lessen and treat RSI. For purposes of this discussion, it is 
presumed that the computer operator is sitting erect with the monitor at 
eye level. 
FIGS. 1 and 2 represents what the inventor has termed the Ergonomic 
Computing Keyboard Position (hereinafter "ECKP") and the Ergonomic 
Computing Mouse Position (hereinafter "ECMP") respectively. It is noted 
that these are not established ergonomic references, rather, these 
anatomic positions serve as a baseline from which movements can be studied 
during the implementation of the apparatus and method of the present 
invention. 
ECKP and ECMP represent the static position of the upper joints during 
computer word processing and data processing. For purposes of discussion, 
the designation "a" will refer to the computer operator's right-side 
extremities while the designation "b" will refer to the computer 
operator's left-side extremities. As illustrated in FIG. 1, in the ECKP, 
the shoulders 2a (not shown) and 2b are internally rotated to bring the 
hands 10a and 10b to the midline of the keyboard. The elbows, 4a (not 
shown) and 4b are flexed 90.degree. relative to the upper arms 12a (not 
shown) and 12b while the forearms 6a and 6b are fully pronated, palms face 
down. The wrists 8a and 8b which are in-line with the forearms 6a and 6b, 
deviate radially and ulnarly during input. In FIG. 2, in the ECMP, the 
shoulder 2b on the side of the body operating the mouse externally rotates 
and abducts slightly from the trunk 14 of the body. The elbow 4b on the 
mouse side remains flexed 90.degree. relative to the arm 12b. The forearm 
6b remains fully pronated and palm facing down. The wrist 8b on the mouse 
side deviates ulnarly slightly. 
In ECKP and ECMP the wrists are at the same level of the forearm 
(approximately 0.degree. wrist extension), the wrist joints may deviate 
inward (radially) towards the center of the keyboard or outwardly 
(ulnarly) toward the right and left boundary of the keyboard. In 
discussing the method and apparatus of the present invention, it is 
important to note that in ECKP and ECMP the forearm is fully pronated 
(i.e. palms down) and will not change during data entry or word 
processing. Any supinated movement of the forearms diminishes keying and 
mouse efficiency. In fact, there is a tendency by individuals to 
hyperpronate the forearms to bring the thumbs and digits into the center 
of the keyboard in an effort to maximize keyboard contact. 
Target Means 
As illustrated in FIG. 3, target means (hereinafter "targets") 20a and 20b 
are attached at the angle between the top and side of the right and left 
corners respectively of the monitor 25 (as viewed by the computer operator 
when facing the monitor). 
As best illustrated in FIGS. 4 and 5, which are detailed views of the 
right-side target 20a, the target of the present invention is structurally 
and mechanically rudimentary. The target may be constructed roughly in the 
shape of a rectangular parallelpiped (cuboid) or a cylinder. In simpler 
terms, the target of the present invention is an elongate member 26, 
having a first end 28 and a second end 30, and an upper 36 and lower 
surface 38, which extends outward from the plane of the monitor screen. 
The first end of the target is fixedly attached to a computer display 
monitor while the second end has a plurality of contact interfaces 
disposed thereon. More specifically, each target comprises an upper 
contact interface 22 disposed upon the upper surface 36 of the target 
means and a lower contact interface 24 disposed upon the lower surface 38 
of the target means, opposite thereof towards which the computer operator 
directs their hands during a series of exercises. The actual targets and 
contact interfaces are fastened at specific angles that are important in 
defining the trajectory of the movement of the limb when it leaves the 
keyboard. 
As shown in FIG. 7, the upper contact interface 22b displaced on the 
left-side target 20b serves as the target for the right hand 10a of the 
computer operator. Similarly, the upper contact interface 22a on the 
right-side target 20a is the destination for the left hand 10b of the 
computer operator. The upper contact interfaces 22a and 22b for the most 
part are oriented to face the ceiling but are inclined 45.degree. outward 
in the plane of the screen. 
Conversely, as illustrated in FIG. 6, the lower contact interface 24b 
displaced on the left-side target 20b serves as the target for the 
left-hand 10b of the computer operator and vise versa. Therefore, the 
operator's right hand 10a will strike the lower contact interface 24a of 
the right-side target 20a while the left hand 10b will touch the lower 
contact interface 24b of the left-side target 20b. Preferably, the lower 
contact interfaces are oriented 45.degree. inward in the plane of the 
screen and also 45.degree. toward the back of the screen/computer. 
The horizontal distance from the right to the left-upper corners of the 
computer monitor is usually between 12" and 20", in those instances when 
the terminal is less than 16" across, the targets will extend outward as 
well as in front of the monitor. Preferably, the targets are sized to 
accommodate two to three finger pulp areas (i.e. fingertips) of the hand. 
The axial length of the elongate member is preferably three to six inches. 
As illustrated in FIG. 4, the target and contact interfaces may be 
manufactured such that the elongate member and contact interfaces are 
separate components. As a further refinement, the contact interfaces may 
be pivotally mounted on a turret-shaped base 32 or utilize a ball and 
socket mount such that the angle and orientation of the contact interfaces 
may be adjusted and fine-tuned. Alternatively, as illustrated in FIG. 5, 
the elongate member and contact interfaces may be manufactured integrally 
(i.e. by injection molding) with the contact interfaces being recessed 
concave regions 34 on the surfaces of the elongate member. In an 
alternative embodiment (not shown), surface indicia may be applied to the 
elongate member. 
The targets of the present invention may be fixedly attached to the 
computer monitor utilizing any method known in the computer pheriphal 
field. For instance, they targets may be secured by use of Velcro.RTM., 
double-sided tape, brackets or support elements. Preferably, the targets 
are secured to such an extent that they can withstand impacts by the 
computer operator similar to the pressure or force applied to the carriage 
bar of a traditional typewriter. Preferably, the movement of the computer 
operator's extremities towards the targets should be controlled, relaxed 
with the contact pressure being relatively light. 
As a further refinement, each target may incorporate a counter means (not 
shown) which registers the number of contacts by the computer operator. A 
reset switch may be utilized to return the counter to zero (0) or start. 
In practice, this counter could be utilized for self-monitoring and 
compliance with the apparatus and method of the present invention. 
Suitable counter mechanisms are well known and will not be discussed 
herein in detail. 
In the present method and apparatus, one right-hand cycle is considered 
complete when the right hand 10a travels to the lower surface interface 
24a of the right-side target 20a and at the next signal to the upper 
surface interface 22b of the left-side target. Similarly, one left-hand 
cycle is completed when the left hand 10b travels to the lower surface 
interface 24b of the left-side target 20b and then to the upper surface 
interface 22a of the right-side target. These left and right sequences 
occur sequentially. A sequence refers to the movement of one of the 
operator's hands to a target (i.e. right-hand to contact upper surface 
interface). As used herein one cycle equals two sequences. 
Software Program 
In the present apparatus and method the signals which prompt the computer 
operator to initiate the exercise cycle of their extremities are software 
directed. This software will run in the background, count keystrokes and 
provide an on-screen prompt to initiate a hand exercise cycle. 
Specifically, the software program directs the computer operator's hands 
toward the appropriate targets at designated intervals. If graphic 
capability is present the appropriate hand signal will be displayed in one 
of the four screen quadrants. The operators' hands simply follow the 
optical stimuli to the appropriate target. Systems which are not 
compatible with visual graphics will rely on text characters to direct the 
sequence of movements. The frequency of the cycle (discussed below) is 
variable and may be selected by the computer operator based upon 
considerations such as age, use, and previous and existing RSI symptoms. 
For instance, the frequency of the cycle may vary depending on whether the 
apparatus and method of the present application is being utilized to 
prevent, lessen or treat the RSI in a particular individual. As shown in 
Table 3, if an individual currently suffers from RSI symptoms, the 
frequency of the cycle will be more often. 
Computer software programs which serve as typing break reminders and 
keystroke counters are well known in the industry and will not be 
discussed at length herein. Specifically, there is already commercially 
available software that is designed to count keystrokes, trigger a break 
or "lock-up" the computer keyboard. One skilled in the computer art could 
readily design a computer program to meet the requirements and criteria of 
the present application. Preferably, the software utilized in the present 
application will be programmable to override the exercise queue if 
desired. 
Table 2 illustrates the increase in range of motion and percent of total 
motion achieved with the apparatus and method of the present invention. In 
this context, one cycles equals two sequences of the right hand. 
TABLE 2 
______________________________________ 
One Hand 
Per- 
cycle centage 
range of 
of the 
ARC OF KEYING motion total 
MOTION USE USE completed 
motion 
Movement (Deg) (Deg) (%) (deg) (%) 
______________________________________ 
shoulder rotation 
90 15 17 85 94 
shoulder 90 20 22 80 89 
abduction/adduction 
shoulder 150 30 20 120 80 
extension/flexion 
elbow 110 25 23 75 83 
extension/flexion 
forearm rotation 
170 10 6 170 100 
wrist 140 35 25 125 89 
extension/flexion 
wrist radioulnar 
45 15 33 35 78 
deviation 
______________________________________ 
Specifically, the two columns on the far right demonstrate the extent of 
the upper joints' movement when using the apparatus and method of the 
present invention. As previously discussed, and shown in the left three 
columns, typical computer input movements (i.e., keying) moves the upper 
joints and extremities very little (left three columns) and this relative 
static environment usually continues until the operator stops and changes 
position, exercises or stretches. The above-referenced table demonstrates 
the beneficial joint movement that can be achieved in one cycle utilizing 
the apparatus and method of the present invention. Since the completion of 
a cycle is software prompted and timed, the computer operator will 
complete numerous cycles during word processing or data input thereby 
realizing the favorable cumulative effect of increasing joint movement at 
regular intervals. The final component of the apparatus and method of the 
present invention is to define the signal for and timing of the exercise 
prompt. 
Timing/Frequency 
As evidenced in Table 2, by utilizing the apparatus and method of the 
present invention, a computer operator may greatly increase the movement 
of the joints of the upper extremities in one cycle. The timing and 
frequency of the exercise queue is based on three variables: 1) number of 
keystrokes; 2) age of the computer operator and the 3) keying health 
status of the operator (i.e. symptom grade). 
Keystrokes are an objective variable and easy to compute. A keystroke is 
defined as any contact with the keyboard which produces a response, 
whether visible on the screen or not (i.e. "shift", "delete" and 
"return"). The present method is based upon a benchmark unit of 75 
keystrokes. However, it is well within the skill of someone in the art to 
modify the sequence for the exercise pattern as discussed herein and 
illustrated in Tables 3. 
The second variable is the age of the computer operator. Computer operators 
&lt;20-35 years are classified as age class CI. Computer operators' 35-50 
years are classified as age class CII. Computer operators &gt;50 years are 
classified as age class CIII. 
The final variable measures the keying health status of the operator (i.e. 
symptom grade). A computer operator who has never had repeating and 
persistent hand pain, numbness and night symptoms is classified as Grade 
1. Grade 2 designates operators who have daily symptoms of hand pain, 
numbness and night symptoms. Grade 3 is reserved for operators who have 
these symptoms almost all the time or immediately upon or shortly after 
keyboard activity. The initiation of a right or left-hand sequence is 
therefore dependent upon the number of keystrokes, age of the computer 
operator and symptom grade. Therefore, as evidenced in Table 3, older and 
more affected operators will complete right and left-hand cycles sooner 
and after less input volume (keystrokes). Younger and less symptomatic 
operators will input or key longer before completing a cycle. 
TABLE 3 
__________________________________________________________________________ 
##STR1## 
__________________________________________________________________________ 
On average, two cycles of hand movements will be completed based upon the 
schedule illustrated in Table 4 
TABLE 4 
__________________________________________________________________________ 
##STR2## 
__________________________________________________________________________ 
In short, it is the number of keystrokes which primarily directs the 
operator response and initiates a cycle. As illustrated in FIG. 8, a 
sequence begins when the right hand is directed to leave the keyboard and 
contact the right lower target. After an additional set of keystrokes, the 
left hand is directed to the left lower target (FIG. 9). Then, as 
illustrated in FIG. 10, the right hand is directed towards and crosses to 
the left upper target after completion of the third sequence of 
keystrokes. After completion of the fourth sequence, the left hand 
contacts the right upper target (FIG. 11). 
It should be emphasized that the provided sequence signals are merely 
examples and may be adapted in either direction (i.e. left-hand to 
right-hand side contact interface and vise versa). Additionally, the 
software of the present apparatus and method may be individually 
programmable by the computer operator or their employer to adjust the 
signal parameters for their particular health status and work environment. 
First Sequence (FIG. 8) 
Signal for the right-hand to contact the right-hand side lower contact 
interface 24a. 
______________________________________ 
Age C I/Grade 1 four lines or 300 keystrokes 
Age C I/Grade 2 three lines or 225 keystrokes 
Age C I/Grade 3 two lines or 150 keystrokes 
Age C II/Grade 1 
two lines or 150 keystrokes 
Age C II/Grade 2 
two lines or 150 keystrokes 
Age C II/Grade 3 
one line or 75 keystrokes 
Age C III/Grade 1 
one line or 75 keystrokes 
Age C III/Grade 2 
one line or 75 keystrokes 
Age C III/Grade 3 
one line or 75 keystrokes 
______________________________________ 
Second Sequence (FIG. 9) 
Signal for the left-hand to contact the left-hand side lower contact 
interface 24b. 
______________________________________ 
Age C I/Grade 1 eight lines or 600 keystrokes 
Age C I/Grade 2 six lines or 450 keystrokes 
Age C I/Grade 3 four lines or 300 keystrokes 
Age C II/Grade 1 
four lines or 300 keystrokes 
Age C II/Grade 2 
four lines or 300 keystrokes 
Age C II/Grade 3 
two lines or 150 keystrokes 
Age C III/Grade 1 
two lines or 150 keystrokes 
Age C III/Grade 2 
two lines or 150 keystrokes 
Age C III/Grade 3 
two lines or 150 keystrokes 
______________________________________ 
Third Sequence (FIG. 10) 
Signal for the right-hand to contact the left-hand side upper contact 
interface 22b. 
______________________________________ 
Age C I/Grade 1 twelve lines or 900 keystrokes 
Age C I/Grade 2 nine lines or 675 keystrokes 
Age C I/Grade 3 six lines or 450 keystrokes 
Age C II/Grade 1 
six lines or 450 keystrokes 
Age C II/Grade 2 
six lines or 450 keystrokes 
Age C II/Grade 3 
three lines or 225 keystrokes 
Age C III/Grade 1 
three lines or 225 keystrokes 
Age C III/Grade 2 
three lines or 225 keystrokes 
Age C III/Grade 3 
three lines or 225 keystrokes 
______________________________________ 
Fourth Sequence (FIG. 11) 
Signal for the left-hand to contact the right-hand side upper contact 
interface 22a. 
______________________________________ 
Age C I/Grade 1 sixteen lines or 1200 keystrokes 
Age C I/Grade 2 twelve lines or 900 keystrokes 
Age C I/Grade 3 eight lines or 600 keystrokes 
Age C II/Grade 1 
eight lines or 600 keystrokes 
Age C II/Grade 2 
eight lines or 600 keystrokes 
Age C II/Grade 3 
four lines or 300 keystrokes 
Age C III/Grade 1 
four lines or 300 keystrokes 
Age C III/Grade 2 
four lines or 300 keystrokes 
Age C III/Grade 3 
four lines or 300 keystrokes 
______________________________________ 
Non-Keyboard Input Devices 
Furthermore, the present invention may be utilized as a prompt and exercise 
target during use of a mouse or other input device. Since the mouse is the 
major non-keyboard entry device it will be used to represent all other 
non-keyboard hand used devices (i.e. trackball, finger pad etc.). Also it 
is assumed that the mouse is used with the right-hand. Therefore a 
left-handed computer operator, upon the appropriate signal, would move and 
contact the right-side target 20a (i.e. the target means opposite). 
For mouse data entry, the present system is based upon a benchmark unit of 
15 seconds of mouse use as the first variable. All other variables (Age 
and Grade) are unaffected. In relation to mouse use there are only two 
sequences: right-hand contacts left-sided upper contact interface 22b and 
right-hand contacts left-sided lower contact interface 24. The 
opposite-side targets are utilized to maximize joint movement because it 
is felt that fine mouse control may be more dangerous to human tissues 
than traditional key entry. 
First Mouse Sequence 
Signal for the mouse-hand (right) to contact the left-hand side upper 
contact interface 22b. 
______________________________________ 
Age CI/Grade1 60 seconds 
Age CI/Grade2 45 seconds 
Age C1/Grade3 30 seconds 
Age CII/Grade1 30 seconds 
Age CII/Grade2 30 seconds 
Age CII/Grade3 15 seconds 
Age CIII/Grade1 15 seconds 
Age CIII/Grade2 15 seconds 
Age CIII/Grade3 15 seconds 
______________________________________ 
Second Mouse Sequence 
Signal for the mouse-hand (right) to contact the left-hand side lower 
contact interface 24b. 
______________________________________ 
Age CI/Grade1 120 seconds 
Age CI/Grade2 90 seconds 
Age C1/Grade3 60 seconds 
Age CII/Grade1 60 seconds 
Age CII/Grade2 60 seconds 
Age CII/Grade3 30 seconds 
Age CIII/Grade1 30 seconds 
Age CIII/Grade2 30 seconds 
Age CIII/Grade3 30 seconds 
______________________________________ 
The present disclosure includes that contained in the appended claims, as 
well as that of the foregoing description. Although this invention has 
been described in its preferred form with a certain degree of 
particularity, it is understood that the present disclosure of the 
preferred form has been made only by way of example and that numerous 
changes in the details of construction and methods and the combination and 
arrangement of parts and method steps may be resorted to without departing 
from the spirit and scope of the invention. 
Now that the invention has been described,