Evaluation of flat, angled, and vertical computer mice and their effects on wrist posture, pointing performance, and preference

Affiliations.

  • 1 Synaptics, Inc., San Jose, CA, USA.
  • 2 School of Public Health, University of Washington, Seattle, WA, USA.
  • PMID: 26444940
  • DOI: 10.3233/WOR-152167

Background: Modern computer users use the mouse almost three times as much as the keyboard. As exposure rates are high, improving upper extremity posture while using a computer mouse is desirable due to the fact that posture is one risk factor for injury. Previous studies have found posture benefits associated with using alternative mouse designs, but at the cost of performance and preference.

Objective: To develop new computer mouse shapes, evaluate them versus benchmarks, and determine whether there are differences in wrist posture, pointing performance, and subjective measures.

Methods: Three concept mice were designed and evaluated relative to two existing benchmark models: a traditional flat mouse, and an alternative upright mouse. Using a repeated measures design, twelve subjects performed a standardized point-and-click task with each mouse. Pointing performance and wrist posture was measured, along with perceived fatigue ratings and subjective preferences pre and post use.

Results: All of the concept mice were shown to reduce forearm pronation relative to the traditional flat mouse. There were no differences in pointing performance between the traditional flat mouse and the concept mice. In contrast, the fully vertical mouse reduced pronation but had the poorest pointing performance. Perceived fatigue and subjective preferences were consistently better for one concept mouse.

Conclusions: Increasing mouse height and angling the mouse topcase can improve wrist posture without negatively affecting performance.

Keywords: Human-computer interaction; design; ergonomics.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Computer Peripherals*
  • Consumer Behavior
  • Equipment Design*
  • Middle Aged
  • Task Performance and Analysis
  • Wrist / physiology*
  • Young Adult

This paper is in the following e-collection/theme issue:

Published on 2.4.2021 in Vol 23 , No 4 (2021) : April

Computer Mouse Movements as an Indicator of Work Stress: Longitudinal Observational Field Study

Authors of this article:

Author Orcid Image

Original Paper

  • Nicolas Banholzer 1 , MSc   ; 
  • Stefan Feuerriegel 1 , Prof Dr   ; 
  • Elgar Fleisch 2, 3 , Prof Dr   ; 
  • Georg Friedrich Bauer 4 , Prof Dr   ; 
  • Tobias Kowatsch 2, 3 , PhD  

1 Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland

2 Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland

3 Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, Zurich, Switzerland

4 Center for Salutogenesis, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland

Corresponding Author:

Tobias Kowatsch, PhD

Centre for Digital Health Interventions

Department of Management, Technology and Economics

Weinbergstr 56/58

Zurich, 8092

Switzerland

Phone: 41 799129133

Email: [email protected]

Background: Work stress affects individual health and well-being. These negative effects could be mitigated through regular monitoring of employees’ stress. Such monitoring becomes even more important as the digital transformation of the economy implies profound changes in working conditions.

Objective: The goal of this study was to investigate the association between computer mouse movements and work stress in the field.

Methods: We hypothesized that stress is associated with a speed-accuracy trade-off in computer mouse movements. To test this hypothesis, we conducted a longitudinal field study at a large business organization, where computer mouse movements from regular work activities were monitored over 7 weeks; the study included 70 subjects and 1829 observations. A Bayesian regression model was used to estimate whether self-reported acute work stress was associated with a speed-accuracy trade-off in computer mouse movements.

Results: There was a negative association between stress and the two-way interaction term of mouse speed and accuracy (mean −0.32, 95% highest posterior density interval −0.58 to −0.08), which means that stress was associated with a speed-accuracy trade-off. The estimated association was not sensitive to different processing of the data and remained negative after controlling for the demographics, health, and personality traits of subjects.

Conclusions: Self-reported acute stress is associated with computer mouse movements, specifically in the form of a speed-accuracy trade-off. This finding suggests that the regular analysis of computer mouse movements could indicate work stress.

Introduction

Stress in the workplace is responsible for over 120,000 deaths and US $187 billion in annual health care spending in the United States [ 1 ]. To mitigate this burden, work stress must be monitored and managed. The need for workplace stress management increases even further as the digital transformation of the economy implies profound changes in working conditions [ 2 ]. At the same time, digital transformation offers opportunities for better stress management. Human-computer interactions with ubiquitous digital devices could be used for real-time monitoring of work-related stress. In particular, it has been shown that the computer mouse responds to changes in muscular activity as a result of stress [ 3 - 6 ]. Thus, previous studies have investigated the association between stress and the use of the computer mouse [ 7 - 11 ], for instance, by analyzing computer mouse movements [ 8 , 10 , 11 ]. However, the evidence from these studies is, so far, based on lab experiments using artificially designed computer tasks. Hence, it remains unclear whether an association between stress and the use of the computer mouse can also be observed in the field.

For this study, we hypothesized that there is an association between stress and computer mouse movements. Our hypothesized association is based on the theory of neuromotor noise [ 12 - 16 ]. Stress, induced by time pressure or multitasking, leads to higher neuromotor noise [ 15 , 16 ], which is the noise in control signals steering motor movements. Lower signal-to-noise ratios and limited capacity to process information lead to adaptive movement behavior [ 12 ]. For instance, if subjects are required to execute fast movements, then neuromotor noise will lead to greater variability in the direction of movement [ 15 ]. The reason for this is that high or low execution speeds induce neuromotor noise, which makes it more difficult to hit the intended target of the movement accurately and requires more or fewer corrections, respectively, along the trajectory [ 13 , 14 ]. That is, the accuracy of the movement has to adjust relative to the movement speed.

In short, the previous literature suggests that stress induces neuromotor noise, resulting in a speed-accuracy trade-off in motor movements. This trade-off is particularly documented in rapid aimed movements [ 13 , 14 ]; based on this, we can expect that it also applies to computer mouse movements. We tested our hypothesis with data from a longitudinal observational field study that included 70 subjects and 1829 observations. Thereby, we collected computer mouse movements and self-reported stress levels from employees during their regular office work for 7 weeks. Using a Bayesian regression model, we present findings that support our hypothesis that work stress is characterized by a speed-accuracy trade-off in computer mouse movements.

Study Design

A 7-week longitudinal field study was conducted at a large European technology company. The company’s human resources director asked 496 employees from different service units (ie, accounting, human resources, information technology, marketing, quality management, logistics, and business development) to participate through an email invitation. The invitation described the study’s objective of understanding the association between computer mouse movements and work stress.

Subjects were not offered financial incentives. However, they were invited to a debriefing event at the end of the study, where the aggregated results were presented. Further, their self-reports were made available to them through graphical diagrams so they could monitor their stress levels over the course of the study.

Among all invited employees, 71 subjects decided to participate. They installed our study software by clicking on a link in the invitation. When subjects first opened the study software, a tutorial explained how the software was used to report stress. During the 7-week study period, the study software asked subjects twice a day to report their stress level. The timings were randomly triggered by our software, namely, once between 9 AM and 11 AM and once between 2 PM and 4 PM. Prior to these self-reports, our software recorded all computer mouse movements for 30 minutes. If subjects were not using their computer at that time (eg, due to a meeting), then no data were recorded.

Data about subjects’ computer mouse movements and self-reports were securely transferred to a server at the organization, from which they were gathered by our research team to perform subsequent analyses. At the beginning of the study, subjects were further asked to report their sociodemographics (ie, age, gender, and education), behavioral attributes regarding health and nutrition (ie, sports, nutrition, smoking, and drinking habits), and expression of the big five personality traits as measured by an established inventory [ 17 ]. All variables are described in Table 1 .

Processing Computer Mouse Movements

A Java application was developed to record computer mouse movements (ie, timestamp and x- and y-coordinates) and mouse events (ie, movement, click, and wheel). The application was built on the Windows operating system’s standard software drivers with a sample rate of approximately 125 Hz. Computer mouse movements were recorded for 30 minutes and processed in the following way. Each recording was split into separate trajectories, where a trajectory started with a mouse movement and ended with a different mouse event (ie, a click or wheel). Thereby, trajectories were only considered if their duration was between 1 and 10 seconds. This approach was beneficial, as it omitted trajectories that were extremely short or included temporary phases where the mouse was not moving. For each trajectory, two variables were computed: (1) mouse speed, which is the average movement speed, and (2) mouse accuracy, which is the proportion of mouse events where the direction of the movement remained equal along the x- and y-axes (ie, the proportion of times the movement direction was not corrected). Both variables were then averaged over all trajectories. These provided the features that were inserted into our regression model.

Mouse speed was computed as the total distance the mouse moved between the start time t =1 of a trajectory and its end time T divided by the trajectory’s total duration T . Hence, this yielded the following:

Mouse accuracy is the relative frequency of how often the movement in x- and y-directions was not changed. It is formalized by the following:

where the variable eqdir t indicates whether the movement in both x- and y-directions remained equal at time t . It returns a value of 1 if this is the case and 0 otherwise. Formally, it is specified by the following:

Accordingly, the larger the accuracy value is, the less the movement direction was altered. If the value for accuracy is 1, then the movement direction was never altered, and if the value for accuracy is 0, then the movement direction was always altered. In other words, the more accurate movement was the one with fewer corrections. This directly relates our measure of accuracy to the theory of neuromotor noise, which predicts more corrections as the movement speed is increased.

The proportion of direction changes is commonly used as a measure of accuracy in related work [ 18 , 19 ]. Another measure for accuracy is the deviation from an optimal trajectory [ 19 , 20 ]. However, the theoretical model underlying the speed-accuracy trade-off predicts that higher movement speed leads to more corrective submovements [ 13 , 14 ], not necessarily to a larger deviation from the optimal line between the start and end point of the trajectory. For that reason, we specifically chose the proportion of direction changes as our measure of accuracy in this study.

Stress Measurement

Acute stress was measured according to the circumplex model of affect [ 21 ]. This model relates affective states to two underlying neurophysiological systems: valence, a pleasure-displeasure continuum, and arousal or alertness [ 22 ]. Both were collected using self-assessment manikins [ 23 ] on a 7-point Likert scale, with a value of 1 referring to a very negative valence (very low arousal) and a value of 7 indicating a very positive valence (very high arousal). Acute stress was then defined as a combination of low valence and high arousal, which has been shown to be related to work stressors in empirical research [ 24 ]. Specifically, stress is encoded as a dichotomous variable that equals 1 if subjects reported low valence and high arousal (ie, valence below the neutral midpoint of 4 and arousal above the neutral midpoint of 4) and 0 otherwise. Hence, our encoding translates into an analysis that focuses on distinguishing negative stress from positive or no stress.

Statistical Analysis

A logistic regression model was estimated with stress as the dichotomous outcome variable and with features from computer mouse movements as the independent variables. The model is specified as follows:

where stress ik is the dichotomous outcome variable for subject i =1,..., M and recording k =1,..., N . Subject-specific variation in average stress levels is captured by the varying intercept α i . Note that subject-specific characteristics such as age or gender could explain between-subject variation of average stress levels, but beyond that, time-varying variables such as computer mouse movements are needed to explain within-subject variation of stress levels over time. The association of mouse speed and accuracy with stress is estimated by β 1 to β 3 . In particular, the two-way interaction between mouse speed and accuracy (β 3 ) tests whether a speed-accuracy trade-off in computer mouse movements is associated with stress. Note that mouse speed and accuracy were centered and scaled by their empirical mean and standard deviation. By centering both variables, the sign of β 3 indicates the direction of the speed-accuracy trade-off. That is, a negative sign of β 3 would indicate that a simultaneous increase in mouse speed and decrease in mouse accuracy or a simultaneous decrease in mouse speed and increase in mouse accuracy is associated with a higher probability of stress.

Further independent variables were included in the above regression model as part of the sensitivity analysis. For instance, to control for mouse usage, we computed the number of events where the mouse was clicked or wheeled. Note that access to other human-computer interactions (eg, keyboard strokes) was not granted in this study due to privacy concerns.

Model Estimation

A Bayesian approach was used for model estimation. Compared to classical statistics, the Bayesian approach requires the specification of priors for all model parameters. When choosing flat priors, the classical and Bayesian approaches are the same. However, when choosing a Bayesian prior (eg, a normal prior), the results are different, and sign errors are less frequent with a Bayesian prior [ 25 ]. In other words, a Bayesian approach is less prone to making wrong claims about the sign of a parameter. In our study setting, this would most likely give more conservative estimates; hence, a Bayesian approach was used for data analysis. We chose weakly informative priors for all model parameters, thereby following recommendations on the choice of priors [ 26 ]. Our priors are as follows:

The model was estimated with Markov chain Monte Carlo using four chains. Each chain performed 2000 iterations divided into 1000 iterations for a warm-up and 1000 iterations for sampling. Samples were drawn with the No-U-Turn Sampler [ 27 ]. Thereby, it was ensured that all Markov chains converged successfully so that inference could be performed. In the Results section, we report the posterior distribution, the posterior mean, and the 95% highest posterior density interval (HPDI) of the estimated parameters.

Statistical analysis was performed with the programming language R, version 4.0.2 (The R Foundation), and the probabilistic programming language Stan, version 2.21.0 [ 28 ], using the interface provided by the R package brms, version 2.13.5 [ 29 ].

Data Inclusion and Exclusion

All participants deciding to participate were included in the study (ie, no additional inclusion or exclusion criteria were applied). Our raw data contained 2029 recordings from 71 subjects. The number of recordings per subject varied due to absences or because the subjects decided to stop participating. Further, recordings were excluded when no computer mouse movements were recorded (5 recordings), the recorded computer mouse movements contained tracking errors (ie, incorrect time stamps) (92 recordings), or when the recordings contained less than 10 computer mouse trajectories (200 recordings). This led to the removal of 297 recordings from 62 subjects—between 1 and 12 per subject—and the exclusion of 1 subject from the study.

Data and Code Availability

Preprocessed data and a script to replicate all model results are provided [ 30 ]. Raw data may be used to identify individual study participants (eg, because mouse movements can be very specific to a person or may reveal sensitive information, such as passwords, when using a software keyboard) and, thus, cannot be made available; this decision was made by the research team and the institutional review board that evaluated the study.

Subject Statistics

Our results are based on 70 subjects and 1829 recordings (mean 26.13, SD 14.33). Subjects were between 20 and 61 years old, with a median age of 39.5 years (IQR 31.0-49.0). Further, 46% (32/70) of the participants were female, and 59% (41/70) held a university degree; all others had high school diplomas or lower. Recordings were roughly balanced by daytime hours (951/1829, 52.0% in the morning and 878/1829, 48.0% in the afternoon) and weekdays (329/1829, 18.0% to 384/1829, 21.0% per weekday and 18/1829, 1% on the weekend).

Both valence and arousal varied across subjects (see Figure 1 ). Average valence per subject was slightly above the neutral midpoint (mean 4.53, SD 0.98), and average arousal was slightly below the neutral midpoint (mean 3.28, SD 1.02). When averaged over the study period, a combination of low valence and high arousal (the top-left quadrant in Figure 1 ) was observed in 12 out of the 70 (17%) subjects. Applying our encoding of stress following the circumplex model of affect [ 21 ], 185 out of the 1829 self-reports (10.1%) were classified as stressful.

research paper about computer mouse

Association Between Stress and Computer Mouse Movements

It was hypothesized that stress is characterized by a speed-accuracy trade-off. This trade-off is illustrated in Figure 2 . When subjects perceived no stress, computer mouse movements were typically not characterized by a speed-accuracy trade-off. In contrast to that, when subjects perceive stress, computer mouse movements were typically characterized by a trade-off where the mouse was moved quickly but less accurately (ie, many direction changes) or slowly but more accurately (ie, few direction changes). Descriptives for average mouse speed and accuracy are provided in Multimedia Appendix 1 , Figure S1.

The estimated parameters of mouse speed and accuracy were as follows. The individual parameters of mouse speed (β 1 ) and accuracy (β 2 ) were not significant based on the observation that the 95% HPDIs include zero (see Figure 3 ). However, the parameter for the two-way interaction between speed and accuracy (β 3 ) was significant (mean −0.32, 95% HPDI −0.58 to −0.08). On average, a simultaneous 1 SD increase in mouse speed and 1 SD decrease in mouse accuracy, or vice versa, was associated with a change in the odds for perceiving stress by 1.53. In other words, work stress was characterized by a speed-accuracy trade-off.

Figure 4 depicts the partial dependence of both mouse speed and mouse accuracy on the probability of perceiving stress. Based on the plot, two findings can be derived. First, stress was more likely when there was a speed-accuracy trade-off. Second, this trade-off seemed slightly more prevalent for low mouse speed and high mouse accuracy, as indicated by a higher share of observations in the lower-right corner. This means that although both directions of the trade-off are present in our data, subjects perceiving stress were slightly more frequently increasing accuracy at the cost of speed.

research paper about computer mouse

Sensitivity Analysis

The sensitivity of the estimated parameters was assessed in the following ways. First, different processing of the data led to conclusive findings. In the above analysis, recordings were removed when fewer than 10 computer mouse trajectories were counted over 30 minutes. When varying this number, the estimated parameter of the mouse speed-accuracy trade-off remained stable (see Multimedia Appendix 1 , Figure S2). Similarly, the maximum duration for a trajectory was set to 10 seconds. When varying the maximum duration from 5 to 20 seconds, the estimated parameter of the mouse speed-accuracy trade-off also remained stable (see Multimedia Appendix 1 , Figure S3). Furthermore, recordings from 2 subjects revealed unusually low mouse accuracy (see Multimedia Appendix 1 , Figure S1). Excluding all recordings from these subjects slightly reduced the size of the estimated parameter for the trade-off (mean −0.22, 95% HPDI −0.42 to −0.03).

Second, the sensitivity of the estimated parameter for the speed-accuracy trade-off was assessed with respect to the inclusion of varying slopes for computer mouse movement variables and additional controls, such as mouse events and sociodemographics. Including varying slopes or adding more controls led to comparable estimates for the parameter of the mouse speed-accuracy trade-off (see Multimedia Appendix 1 , Figure S4).

Third, the association of computer mouse movements with valence, arousal, and a discrete measure of stress (defined as arousal – valence + 6) was estimated. Results from Poisson regressions with the same model specification showed no significant associations but a tendency that arousal and the discrete measure of stress were negatively associated with the speed-accuracy trade-off (see Multimedia Appendix 1 , Figure S5). However, the results from the regression with the discrete measure of stress as the outcome should be interpreted with caution, as an arousal level of 7 and valence level of 4 would result in the equivalent level of stress as an arousal level of 5 and a valence level of 2, whereas only the second self-report would be labeled as stress according to the circumplex model of affect.

Fourth, the possibility of selection bias was investigated, with a statistical comparison between those subjects with few (n≤10) and many (n>10) recordings. The proportion of recordings with stress from subjects with few recordings (6/43, 14%) was higher than the proportion of recordings with stress from subjects with many recordings (188/1986, 9.5%). However, the difference was not statistically significant (χ 2 1 =0.5, P =.47). This result suggests that participation intensity was not significantly related to stress. Other than that, it could not be investigated whether individuals outside this study were more or less stressed than the subjects participating in this study.

Principal Findings

The goal of this study was to examine whether computer mouse movements indicate work stress. Data from a 7-week longitudinal field study supported the hypothesis. Despite the heterogeneity of computer tasks and the resulting complexity of computer mouse movements, we found a significant association with work stress. That is, work stress was characterized by a speed-accuracy trade-off in computer mouse movements.

Comparison With Prior Work

This is the first study to infer stress from the computer mouse in the field (ie, at the workplace). In prior work, lab studies were conducted to investigate the association between stress and the use of the computer mouse [ 7 - 11 ]. In these lab studies, subjects performed artificial tasks (eg, point-and-click tasks) in a controlled environment. In contrast to that, our data were collected unobtrusively while subjects were performing office work in a real-world environment. On the one hand, this made data processing and analysis challenging. On the other hand, it provided us with the unique opportunity to present the first empirical evidence as to whether stress is associated with computer mouse movements in the field.

A drawback of our field study in comparison to the lab studies is that we are not able to estimate a causal link. The reason is that there are potentially unmeasured confounders. In particular, computer mouse movements as well as stress may depend on the difficulty of the task, with more difficult tasks resulting in higher levels of stress. In the lab, it is possible to control which task is performed, whereas this is not possible in the field without obtrusive monitoring of tasks. However, precisely because unobtrusive and continuous monitoring of tasks is not feasible in the field, computer mouse movements may be a good proxy for how stressful a task is perceived and may thus provide an indirect way to measure stress.

Monitoring of computer mouse movements provide a number of benefits for stress management in the workplace. Most office work involves computer tasks; as such, computer mouse movement data are readily available. Unlike other forms of stress monitoring, computer mouse movements present a viable tool for monitoring stress at scale because they can be collected in an unobtrusive fashion and continuously over time [ 10 ]. The latter becomes important when offering on-demand stress management interventions by organizations and for monitoring their effectiveness [ 31 ]. It is also possible to monitor stress by monitoring physiological changes (eg, heart rate variability or skin conductivity) through wearable devices. However, when introduced by employers, the broad usage of physiological data in a corporate context raises issues regarding their acceptance and legitimacy [ 32 ]. When compared to such physiological stress measurements, many employees might consider the measurement of computer mouse movements as a clearly work-related behavior and as a less intrusive and more legitimate monitoring method at work. As computer mouse movements are bound to currently performed work, their measurement will trigger a more balanced action on the part of employees to mitigate work stress: both reducing their own receptivity to stress and improving the underlying working conditions, as it is also recommended by the European Union [ 33 ]. Thus, the measurement of computer mouse movements offers a valuable, complementary approach to physiological measurements.

Limitations

Our study also has limitations. First, our work constitutes an observational study with an explanatory analysis of the data. As a consequence, a causal interpretation of the estimated association is precluded. Second, computer mouse movements were only linked to the presence of stress, which was defined according to the circumplex model of affect [ 21 ]. The severity of stress could not be assessed due to the low prevalence of high levels of stress. Third, computer mouse movements were only linked to acute stress. The association of computer mouse movements with chronic stress is subject to future work. Fourth, the outcome of this study was psychological stress, which was measured based on self-reports. It is unclear if, and to what extent, psychological and physiological measures of stress are alternative or complementary by nature [ 34 ]. Thus, collecting physiological data from wearable devices to monitor stress [ 35 , 36 ] could be used to validate the association with computer mouse movements. Fifth, the sources of stress were not identified, which is important for managing stress. However, other work suggests that human-computer interactions also correlate with workplace stressors [ 37 ]. Sixth, the determinants for the directions of the speed-accuracy trade-off were not explored. This would probably require a different research setting, most likely a controlled lab experiment, in order to investigate what causes subjects to increase speed at the cost of accuracy, or vice versa.

Conclusions

To summarize, the findings of this study suggest that the computer mouse can be used to infer work stress. These findings could be combined with findings from other forms of human-computer interactions (eg, computer trackpads [ 38 ] or keyboard strokes [ 39 ]) in order to develop digital tools for detecting stress.

Acknowledgments

We would like to thank Andreas Filler for developing the software that allowed us to perform the computer mouse movement and self-report recordings. NB and SF acknowledge funding from the Swiss National Science Foundation outside of this study.

Conflicts of Interest

EF and TK are affiliated with the Center for Digital Health Interventions, a joint initiative of the Department of Management, Technology and Economics at ETH Zurich and the Institute of Technology Management at the University of St. Gallen, which is funded in part by the Swiss health insurer CSS. EF and TK are also cofounders of Pathmate Technologies, a university spin-off company that creates and delivers digital clinical pathways. However, Pathmate Technologies was not involved in the study described in this paper.

Supplementary figures for descriptives and sensitivity analyses.

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Abbreviations

Edited by G Eysenbach; submitted 13.01.21; peer-reviewed by A Göritz, J Zhang; comments to author 05.02.21; revised version received 16.02.21; accepted 25.02.21; published 02.04.21

©Nicolas Banholzer, Stefan Feuerriegel, Elgar Fleisch, Georg Friedrich Bauer, Tobias Kowatsch. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.04.2021.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

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Designing a New Computer Mouse and Evaluating Some of Its Functional Parameters

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BACKGROUND: Due to its rapid growth in popularity, there is an imminent need for ergonomic evaluation of the touch-screen tablet computing form-factor. OBJECTIVE: The aim of this study was to assess postures of the shoulders and wrists and their associated muscle activity during touch-screen tablet use. METHODS: Fifteen experienced adult tablet users completed a set of simulated software tasks on two media tablets in a total of seven user configurations. Configurations consisted of a combination of a support condition (held with one hand, two hands or in a case), a location (on the lap or table surface), and a software task (web browsing, email, and game). Shoulder postures were measured by using an infra-red LED marker based motion analysis system, wrist postures by electro-goniometry, and shoulder (upper trapezius and anterior deltoid) and forearm (flexor carpi radialis, flexor carp ulnaris, and extensor radialis) muscle activity by surface electromyography.RESULTS: Postures and muscle activity for the wrist significantly varied across configurations and between hands, but not across the two tablets tested. Wrist extension was high for all configurations and particularly for the dominant hand when a tablet was placed on the lap (mean=38°). Software tasks involving the virtual keyboard (e-mailing) corresponded to higher wrist extensor muscle activity (50th percentile=9.5% MVC) and wrist flexion/extension acceleration (mean=322°/s<formula>^{2}</formula>). High levels of wrist radial deviation were observed for the non-dominant hand when it was used to tilt and hold the tablet (mean=13°). Observed differences in posture and muscle activity of the shoulder were driven by tablet location. CONCLUSION: Touch-screen tablet users are exposed to extreme wrist postures that are less neutral than other computing technologies and may be at greater risk of developing musculoskeletal symptoms. Tablets should be placed in cases or stands that adjust the tilt of the screen rather than supporting and tilting the tablet with only one hand.

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Objectives: Mouse is one of the most important data entry devices for computers. Undesirable and prolonged postures during work with the computer mouse increase workload, muscle aches and upper extremity musculoskeletal disorders. The present study aimed to evaluate and compare muscle activity during the use of 4 types of mouse, including trackball, trackpad, slanted and standard by Electromyography (EMG). Methods: This experimental study included 15 subjects (7 men and 8 women). The electrical activity of EDC, ECU, ECR, FDS, PQ, and FDL muscles was recorded by EMG while performing a standard task with each mouse. The order of using each mouse was randomized. The obtained results were analyzed by SPSS using the measures of central tendency, Friedman's test, and Independent Samples t-test. Results: The results of assessing the electrical activity level of muscles suggested no statistically significant difference in the recorded EMG between FPL, FDS, and PQ muscles while working with the 4 mice. The electrical activity reduced in EDC, ECR, and FPL muscles with the use of slanted mouse, compared to that of other mice (P<0.05). Discussion: There was no significant differences between the electrical activity of FDS, FPL, and PQ muscles during work with the studied mice. Furthermore, the activity of EDC, ECR, and FPL muscles reduced during work with a slanted mouse, compared to the other types. The habit of using a new mouse can affect the level of muscle activity; thus, the use of a slanted mouse may reduce the incidence of musculoskeletal disorders in the wrist and hand of users in the long run.

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  • v.22(5); 2014 Oct

Occupational Overuse Syndrome (Technological Diseases): Carpal Tunnel Syndrome, a Mouse Shoulder, Cervical Pain Syndrome

Merita tiric-campara.

1 Neurology Clinic. Clinical Center of Sarajevo University. Sarajevo, Sarajevo, Bosnia and Herzegovina

Ferid Krupic

2 Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenbug, Sweden

Mirza Biscevic

3 Orthopaedics and Traumatology Clinic. Clinical Center of Sarajevo University. Sarajevo, Bosnia and Herzegovina

Emina Spahic

4 Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Kerima Maglajlija

Zlatan masic.

5 XION Company, Vienna, Austria

Lejla Zunic

6 Faculty of Health Sciences, University of Zenica, Zenica, Bosnia and Herzegovina

Technological diseases are diseases of the modern era. Some are caused by occupational exposures, and are marked with direct professional relation, or the action of harmful effects in the workplace. Due to the increasing incidence of these diseases on specific workplaces which may be caused by one or more causal factors present in the workplace today, these diseases are considered as professional diseases. Severity of technological disease usually responds to the level and duration of exposure, and usually occurs after many years of exposure to harmful factor. Technological diseases occur due to excessive work at the computer, or excessive use of keyboards and computer mice, especially the non-ergonomic ones. This paper deals with the diseases of the neck, shoulder, elbow and wrist (cervical radiculopathy, mouse shoulder and carpal tunnel syndrome), as is currently the most common diseases of technology in our country and abroad. These three diseases can be caused by long-term load and physical effort, and are tied to specific occupations, such as occupations associated with prolonged sitting, working at the computer and work related to the fixed telephone communication, as well as certain types of sports (tennis, golf and others).

1. INTRODUCTION

Computers are considered as an integral part of everyday life in today's work and life ( 1 - 5 ). They are used in a wide variety of professions from banking, health, communication to entertainment and leisure time. “Thanks to the” great use of computers, occurs the diseases of the modern era, which one of the authors of this article named “Technological diseases” – Carpal Tunnel Syndrome (CTS), a Mouse Shoulder (MS) and Cervical Pain Syndrome (CPS). Within past a few decades rapidly increased automation of offices and very few authors in the scientific literature have reported about positive association between computer use and musculoskeletal symptoms as consequences ( 6 - 10 ). Under term of“Technological diseases” we mean the diseases caused by the harmful influence of the job in the first place, the working position in which it is involved excessive work on a computer, such as the banking sector, the health sector and many others who are directly or indirectly connected with the work on the computer and overuse of keyboard and computer mice, which are in large number of cases of non-ergonomic, and inappropriate for a hand. It is therefore recommended to use ergonomic computer mice. Using them can prevent diseases of the modern era, technological diseases associated with prolonged sitting and working on a computer such as Carpal Tunnel Syndrome, Cervical syndrome, and certainly the most interesting for the many unknown, but not less important disease, mouse shoulder an increasingly common diagnosis in clinics of family medicine. These diseases are described in more detail in this paper ( 11 - 20 ). In Bosnia and Herzegovina to overuse injuries has not paid enough attention from the medical nor the social and economic aspects, although it is evident that large amounts of funds are allocated for treatment and rehabilitation of these diseases. In Clinical Center University of Sarajevo in the cabinet for EMNG of the Neurology clinic, monthly are diagnosed 10 cases with carpal tunnel syndrome, while cases of cervical syndrome is in a significant expansion during last 5 years which more and more represent not only a medical but also social economic problem ( 21 - 23 ).

2. CARPAL TUNNEL SYNDROME

Carpal tunnel syndrome (CTS) is the most common canaliculus syndrome resulting from pressure on the central nerve (median nerve) in the carpal tunnel (lat. canalis carpi) and reflected in reduction of sensation, pain, paresthesia (numbness, tingling), and muscle weakness in the hands and forearms.

The median nerve in its course passes through the carpal canal ( Figure 1 ). The bones of the hand (lat. ossa carpi) make gutter channels, and rectangular connection (lat. retinaculum flexorum) covers the channel. In the channel along with the nerve are located tendon flexor muscle of fingers, m. pronator teres, m. pronator quadrates, m. flexor carpi radialis, m. palmaris longus, m. flexor carpi ulnaris, m. flexor digitorum superficialis et profundus and m. flexor policis longus. All these muscles supplying the median nerve. Carpi ulnaris M.flexor the inner half, m. Flexor digitorum profundus is innervated by n. ulnaris.

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Object name is AIM-22-333-g001.jpg

The muscles of the forearm.

Carpal tunnel syndrome (CTS) was first described in the mid-1800 by James Paget's ( Figure 1 ). The world's best known as peripheral compressive neuropathy and one of the fastest growing technology diseases in the United States. At least 1 out of 10 people develop this disorder or suffering from the symptoms of this syndrome. This is one of the most common causes of absenteeism in the workplace and disability in the United States ( 2 )

Signs and symptoms are: a) pain in the palm of the hand, especially near the thumb and first two fingers; b) numbness and tingling often occur in the thumb and first two fingers; and c) weakness, usually thenar eminence (muscles at the base of the thumb), can occur when a severe clinical picture ( Figure 2 ) ( 3 ).

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Sensory innervation of the median nerve in a hand

Compression of the nerve in the carpal tunnel (carpal tunnel syndrome) is recognized as the impact of trauma and attributed to tenosynovitis of the rheumatoid arthritis. Even since 1954, Albert and his colleagues concluded that there are numerous reports describing the spontaneous development of carpal tunnel syndrome of unknown pathogenesis ( 4 ).

In case of a longer duration of illness and long-term nerve compression, there is an unnecessary prolongation of the patient discomfort, severe nerve damage, prolonged recovery time after surgery, and generally reduced chances for successful surgical treatment. Thereby reducing the working ability of the patient, leading both to the individual and to the socioeconomic consequences.

At the Department of Orthopedic Surgery, Faculty of Medicine, University of Zagreb, and Zagreb University Hospital Center is conducted a retrospective study on 114 patients and 154 hands with CTS that were surgically treated between 1999 and 2004. In this study, it was found that patients in only 52% of cases within one year since reporting to the physician were referred to an orthopedist. In the period prior to surgical treatment, 96.1% of patients were treated by physical therapy, although all eventually underwent a surgical procedure, and 42% of patients in the same time period it was on sick leave, usually from three to six months. The results demonstrate that the timeliness of surgical treatment is essential to the success of the outcome of the procedure, and that the time which elapses from entering the patient's health care system to the surgical treatment of unnecessary cost.

This situation, besides being detrimental for the patient, and leads to unnecessary economic losses include the expense of physical therapy and absenteeism. The patients involved in the study in question is estimated that these economic losses, in the period prior to surgical treatment, for several hundred thousand Euros higher than in the postoperative period.

From this stems the need for shortening the period of time that has elapsed since entering the patient in the health care system to its referral to an orthopedic clinic, so as to accelerate the processing and diagnosis of the patient, i.e. shortened unnecessarily long period of nonsurgical treatment. Accordingly, physical therapy is helpful in the treatment ( 5 ).

In the diagnosis of CTS we also use provoking tests of which we will mention four that are suitable for use in general practice. These are the Tinel, Phalen, Bilic and Tourniquet test. Tinel's test is positive if the percussion in the carpal ligament is followed with occurrence of pain and/or paresthesia. Phalen's test is performed so that the wrist is placed in the second forced palmar flexion for 60 seconds, and is positive if within this time span occurs pain and/or parasthesias ( Figure 2 ). Compression of median nerve in this position with carpal tunnel syndrome causes the characteristic symptoms of burning and tingling ( 6 ).

Bilic test is performed in palmar flexion of the wrist by 45 degrees by pressing above the median nerve in the distal ridges and mid wrist for 30 seconds. The test is positive if within this time span occurs pain and/or paresthesia. Tourniquet test is performed so that the cuff pressure gauge is mounted on the upper arm and inflated above the systolic pressure value. The test is positive during 60 seconds occurs pain and/or paresthesia in the innervation area of median nerve.

Alongside this symptom, electrical neurophysiological diagnostic is the“gold standard” in the diagnosis of carpal tunnel syndrome, in order to determine the exact location of nerve compression, and in order to set the indication for surgical treatment ( Figure 3 , ​ ,4, 4 , ​ ,5) 5 ) ( 6 ).

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Object name is AIM-22-333-g003.jpg

EMNG median nerve recording procedure

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EMNG: Motor Conduction Velocity of nervus medianus

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Object name is AIM-22-333-g005.jpg

EMNG: Sensory Conduction Velocity of nervus medianus

In the case of known primary disease that caused Carpal tunnel syndrome the primary disease is treated first. The conservative methods of treatment include immobilization, local application of corticosteroids and avoidance of chronic, repeated trauma. If the cause of the syndrome is mechanical compression, the treatment is surgical (cutting of retinaculum flexorum).

In Turkey was conducted a study that suggests that treatment with vitamin B6 improves clinical symptoms as well as sensory and electro diagnostic results in patients with carpal tunnel syndrome, and therefore it is advisable to treat carpal tunnel syndrome with vitamin B6 ( 7 ).

Another study in Turkey was carried out at the Institute of Neurology in cooperation with the Clinic for Physiotherapy in which patients were included with carpal tunnel syndrome. They are divided into two groups, one in the treatment arm used immobilization and massages, while the other control group used only immobilized arm.

The study results showed that the massage of the painful area only in patients with carpal tunnel syndrome is sufficient for mild cases.

This was also one of the biggest studies with massage treatment in patients with carpal tunnel syndrome. The researchers recommend self-administration of massage methods, and this would reduce the time to go to the doctor and rehabilitation centers, and thereby save money, both for health funds, and patients ( 8 ).

Manipulation (effleurage): Thirty seconds smoothing the skin's surface, from distal to proximal forearm. Friction: sixty seconds, massaging the deep tissues from the distal to proximal. ( 8 )

3. CERVICAL PAIN SYNDROME

Cervical pain syndrome (CPS) refers to a range of disorders caused by changes in the cervical spine and soft tissue surrounding it, with pain as the predominant symptom. Neck pain is a common problem for a large portion of today's population.

Factors contributing to this problem are the modern way of life, prolonged sitting and inadequate, fixed or artificial positions. The root of these problems is found in the mechanical disorders of the cervical spine, poor posture and quick movements of the body ( 9 ).

Anatomical specificity of the cervical spinal column are: a small side vertebral joints that cervical spine provide great mobility, transversaria foramina through which the vertebral artery (C6-C2) and the spinal cord enters in the vertebral canal.

Cervical radiculopathy causes symptoms that radiate from the neck. Although the problem is in the spine, the symptoms can be felt in the shoulder or arm. Symptoms will be felt in the area where the nerve is in its path.

By clinical examination of the spine the specialist can usually determine which nerve is involved. Symptoms include pain, stiffness and weakness. Reflexes on the upper arm may be affected. ( 10 ).

Risk factors for radiculopathy are activities that put excessive or repetitive load on the spine. Patients involved in heavy work or are in contact sports, are more prone to the development of those with radiculopathy more sedentary. A family history of radiculopathy or other spine disorders also increase the risk of developing radiculopathy ( Figure 6 ) ( 11 ).

An external file that holds a picture, illustration, etc.
Object name is AIM-22-333-g006.jpg

Example of cervical syndrome caused by disc herniation with reduction of liquor space (Source: I.M.)

In the younger population, cervical radiculopathy is the result of disc herniation or acute injury. In the older population, cervical radiculopathy is often the result of foramen narrowing and the formation of osteophytes then reduced the amount of disk and degenerative changes in the joints ( 12 ).

Cervical syndrome classification:

CERVICAL SYNDROME patients complain of pain in the neck that occurs gradually or abruptly, after taking a certain position, rapid or uncontrolled movements of the neck or cooling.

CERVICOCEPHALIC SYNDROME usually develops as a result of irritation or compression of the nerve roots C1-C3. The main symptom is headache of varying character and intensity. Headache is localized in the neck with a tendency to spread to the shoulders, the face, orbital or auricular region.

CERVOCOBRACHIAL SYNDROME result is irritation or compression of the nerve roots C4-C8, mostly due to prolapse of the intervertebral discus, severe degenerative changes or injury.

VERTEBROBASILAR SYNDROME occurs as a result of irritation of the last cervical sympathetic with fiber mesh wrap vertebral artery, causing reflex vascular disorders in the vertebrobasilar basin.

Irritation commonly caused by degenerative changes in the cervical spine: spondylosis (osteophytes), uncarthrosis, spondylosis. Atherosclerosis can worsen symptoms ( 13 ).

The typical clinical presentation of patients with cervical syndrome is characterized by the presence of pain and sensitivity in the muscles back of the neck with the spread of pain in the back of the head, shoulders or scapular region ( Figure 6 ). The sensitivity of the muscle can occur during execution of one or more movements, and the headache is a common symptom.

Symptoms and signs are: a) pain in the neck, which may be sharp or blunt; b) the tension in the neck; c) painful and limited mobility; d) inability to perform daily duties due to stiffness in the neck; e) pain in the shoulders and arms associated with pain in the neck; f) fainting; g) dizziness; h) tinnitus; i) blurred vision; j) headache; k) diplopia; l) weakness; m) feeling of heaviness, tenderness and paresthesia in the upper extremities; n) impaired concentration and memory, etc. ( 13 ).

Diagnostic imaging such as magnetic resonance imaging, computerized tomography, or myelography should be used as a strategy for assessment. Electromyography is useful in differentiating between the various entities when distinguishing clinical diagnosis. Treatment of this disorder has not been studied systematically in a controlled manner. However, using a variety of treatments, radiculopathy usually improves without the need for surgery. Indications for surgery were persistent pain, increased weakness, or new or progressive process. Future studies evaluating different treatment options will be helpful in guiding practitioners towards optimal economic evaluation ( 13 ).

The goal of treatment is absolutely the same as for any other illness. Always seeks the same goal, or cure, and if this is not possible, at least alleviate symptoms and apply palliative care. Since we are talking about a technological disease that affects more and more to older and younger people should therefore work on the prevention of disease. It is very important to advise patients about lifestyle, how to maintain mobility and that despite the difficult situation improve the quality of life.

Treatment without medicationshould be: a) massage hot/cold; b) rest; c) exercises with light stretching (gently stretch your neck to one, then the other aside and keep 30 seconds); d) exercises for neck recommended by physiologists; e) transcutaneous electrical stimulation (TENS); f) short-term immobilization; g) surgical treatment; h) acupuncture; i) traction (enlargement of the intervertebral space), j) medicamentous treatment:

Early and adequate treatment with analgesics, anti-inflammatory drugs, muscle relaxants and help with sleep problems are carriers of pharmacological treatment in patients with neck pain ( 14 ).

Performed is a study on how the steroid injections affect the reduction of pain in patients with cervical syndrome, who are waiting for surgery discus, and whether the possible suspension of surgical treatment.

Transforaminal injection of steroids has gained popularity with the explanation that the inflammation of nerve roots causing radicular pain, and because steroids are placed on the local level should relieve symptoms.

Prospective–cohort study indicates a decrease in the need for surgical treatment because of treatment-injection steroid injections. The clinical effect is measurable and statistically significant improvement registered radicular pain ( 14 ).

Another in a series of studies on the treatment of cervical syndrome confirmed the effectiveness of acupuncture in the cervical region of patients with radicular symptoms. Favorable results have been seen in almost 90% of cases. These results indicate that treatment of acupuncture cervical region can be effective as the conservative therapy for the treatment of cervical radiculopathy ( 15 ).

4. MOUSE SHOULDER

Computers are considered as an integral part of everyday life. They are used in education, health and medicine, science, banking, recreation and entertainment, politically engaged people ( 16 ). Approximately 75% of jobs are dependent on the work on the computer ( 17 , 18 ).

Chen and colleagues examined the effect of five computer mice made at different angles in 12 respondents employed in the business sector in Taiwan. They concluded that too frequent use of non ergonomic computer mice causes extreme discomfort in the muscle and tendon system of the hand along with various manifest symptoms in the shoulder and forearm. The use of ergonomic mice custom hand shape, thanks to the different corners of the obliquity have less adverse effect on the activity of the forearm and shoulder. ( 19 )

The shoulder belt is common, even among the most frequent localization of musculoskeletal pain after pain in the back and knees ( 20 ).

The long-term work at the computer leads to inflammation of tendons and exchanges shoulder joint, and in severe cases can lead to tearing of tendons and muscles “rotator cuff”. If inflammation persists, the capsule and ligaments of the shoulder joint becomes stiffer and limited mobility. Inappropriate placement of computers may have adverse effects on posture in children ( 21 ).

Limited and painful mobility is especially pronounced when raising your arms above your head or behind your back. Long-term pain becomes stronger and leads to the development of muscle weakness areas of the shoulder belt through a series of hands, and preventing further activities.

Symptoms of pain in the shoulder differently vary from intense that it can spread to other parts of the body, to moderate that lingers on the shoulder belt, but still hinder the function of the hinge, and can even lead to sleep disorders.

The anatomy of the shoulder is a specific because the shoulder joint consists of primary, secondary and ancillary wrist joints. The anatomical structure makes the most complex joint of the body. Joints shoulders: glenohumeral joint (shoulder joint primary), Scapulothoracic joint (secondary shoulder joint), and sternoclavicular joint (extra joints).

Muscle groups that may be a potential source of pain are rotator cuff (responsible for balance of the glenohumeral joint), stabilizing the scapula (responsible for the position of the scapula) the primary drivers (responsible for the strong movements).

For the diagnosis of mouse shoulder, the most important is detailed history with regard to occupation and profession of the patient and physical review. We should not forget to examine whether the patient has in the past had a shoulder injury, or some localized inflammation in the same.

Information about the character, pain intensity and directions of its expansion are of great importance. In fact it is necessary to establish that the primary cause of shoulder pain, and that the anatomical structure of the shoulder is affected. It is known that the pain can be transmitted from the adjacent region to the shoulders, for example. The cervical region, or by visceral fibers of the heart.

In equivocal cases, x-rays of the shoulder joint may help in differentiating existing inflammation of the joints and structure surrounding joint of a possible slight shoulder dislocation.

The primary method for the treatment of mouse shoulder in a timely manner to reduce the strain on shoulders, mostly working with computer mouse.

If the patient is in question, and cannot make a break, they definitely need the to replace old with new ergonomic computer mouse that is adapted to grip and allows the natural position of the hand during mouse use.

NSAIDs are the first drugs of choice. In the long-term intractable pain states and may prescribe therapy application of corticosteroid injections in the shoulder joint. An indispensable aspect of therapy is physical therapy. Physical therapy is appropriate in the chronic phase of the disease, which aims to stabilize and strengthen the muscles of the shoulder belt, and the resultant reduction in pain.

Jan C. Winters and colleagues came to the conclusion that only 50% of patients with newly diagnosed painful condition experience a full recovery within the first 6 months. This percentage rises to 60% in the first year of the onset of pain. They also proved that speaking to the long-term treatment, at the end of treatment, there was no difference in effect between the corticosteroid and physical therapy ( 22 ).

Onyebeke LC investigated the effects of props during the use of the mouse on the palm, forearm and upper extremities, and came to the result that 90% of respondents who have used the support arm had less pain in the shoulder girdles of those who are not used to. The use of any support results in less tension, and less applied force to a computer mouse during operation, and therefore less hassle and pain in the shoulder ( 23 ).

5. PHYSICAL REHABILITATION AND PREVENTION OF TECHNOLOGICAL DISEASES

5.1. the role and organization of the centers for physical rehabilitation (cbr).

If the patient required outpatient treatment, family doctor referred him Physiotherapy in CBR (Community based rehabilitation) i.e. the center for rehabilitation in the community. CBR's are organized within the framework of primary health care and are located within the health centers. CBR–rehabilitation in the community–the definition of a Joint Paper, ILO, UNESCO, WHO, in 1994.

Community rehabilitation strategy based on community development for the rehabilitation, equalization of opportunities and social integration of people with disabilities, their families and communities and the appropriate health of educational, professional and social services.

Community rehabilitation allows people with disabilities to take initiative and improve their own lives, and to contribute to the community, and not just use the funds and resources that are available. Thus, the entire community and all its members are winners.

CBR became the backbone of the carrier non-institutional organization of the program in physical medicine and rehabilitation of persons with disabilities as well as a large number of chronically ill patients in the prevention of disability.

5.2. The forms of work in the CBR

Rehabilitation system reaches into every community rehabilitation team becomes more flexible and actively participate in all aspects of rehabilitation. Rehabilitation includes all age groups.

Treatment in the community increases the accessibility and quality of services for people with disabilities and their families.

Services include primary treatment damage and disability in the center and at home, as well as patient education, health promotion and prevention of disease and disability.

CBR Team composition: a) 1 medical doctor specialist in physical medicine and rehabilitation; b) 1 physiotherapist; c) 1 occupational therapist; d) 2 medical technicians–physiotherapist; e) Medical technician–general direction; f) 0.5 Social Worker; g) 0.4 special education teacher-speech therapist.

5.3. The most common reasons for referral of patients in the CBR

The most common reasons due to which family physician refers patients to the ambulance treatment in rehabilitation centers in the community are:

Adult patients: a) Cervical pain syndrome; b) Lumbar pain syndrome; c) Rheumatic diseases; d) Rehabilitation after stroke. Children and young people: a) Neurorisk children; b) Deformities of the spinal column; c) Deformities of the lower extremities; d) Rehabilitation after injuries of the locomotor apparatus

6. ACCREDITATION STANDARDS RELATED TO PHYSICAL REHABILITATION

Standard 5I: Center/Service for Physical Rehabilitation

Health Center promotes the concept of active participation of disabled people and their families in identifying needs and resources in rehabilitation develop a shared vision of their life in society, the implementation of the vision and the monitoring and evaluation of implementation.

5I.295 Within the health center there is a center for the rehabilitation of disabled persons (CBR) with support groups and self-help.

5I.296 center is managed by the appointed specialist in physical medicine and rehabilitation.

5I.297 Depending on the systematization of jobs, the Centre employed physiotherapy technicians, occupational therapists, nurses, general direction.

5I.298 Physical therapists adhere to the Code Company physiotherapists with permission to work in practice.

5I.299 specialist in physical medicine and rehabilitation therapists are members professional organizations that provide guidance on continuing professional development.

5I.300 All employed staff in service has a documented plan for ongoing personal professional development that includes measurable goals for learning.

5I.301 There is evidence in writing of actions taken on the permanent professional development that reflects the plan.

5I.302 There are dated, documented criteria for referring patients to physical therapy. The criteria are written/reviewed in the past three years.

5I.303 There are dated, documented procedures on granting new cases to team members for physical therapy. The procedure is written/rewritten in the past three years. Instructions: Cases should be awarded according to the skills and experience required for the indicated treatment, together with the need for equitable distribution of the number of cases.

5I.304 There are documented procedures on the regulation of proper completion of the treatment of patients having implemented the rehabilitation plan. The procedure is written/rewritten in the past three years.

5I.305 estimated needs of the patient/user for the physical treatment by physical examination which receives measurable data for evaluation.

5I.306 Each patient was referred to physical therapy has an individual rehabilitation plan for the implementation of physical therapy.

5I.307 Before each procedure/treatment is carried out risk assessments. Note: This includes risk assessment, contraindications to treatment and precautions. Also, include the verification of hazards such as wet floors, and the provision of suitable clothing and shoes worn by therapists and patients/users.

5I.308 rehabilitation program undertaken only after the results of the risk assessment.

5I.309 risks associated with the use of electrical equipment reduces the use of safety switches.

5I.310 Before using the apparatus and its application to a patient, is made visual and physical verification of security equipment.

5I.311 There is plenty of space and are available partitions/curtains in the room/rooms for physiotherapy treatment that patients provide visual privacy when using the equipment.

5I.312 equipment is kept in a place where not to interfere with access to fire exits, entrances, hallways and other equipment.

5I.313 Health Centre organizes regular meetings for people with disabilities and their family members, performs basic assessment of their needs and implements early education and basic rehabilitation programs under the guidance of an appropriate therapist.

5I.314 health center, or CBR, is developing a multi-sectoral cooperation and contracts with appropriate institutions for labor and social policy, education, institutes Employment, sports institutions, etc. Panel evidence-based clinical practice guidelines on musculoskeletal rehabilitation interventions,

7. DISCUSSION AND RECCOMENDATIONS ON THERAPEUTIC MODALITIES

Several studies have reported possitive or negative association between computer use and musculosceletal symptoms ( 24 - 26 ). The prevalence of Computer Carpal Syndrome (CTS) among computer professionals based on clinical signs and sympoms is approximately 13,1% and almost 1 out of every computer professional suffers from this condition. Very few data published about this topic – studies about CTS prevalence based on clinical signs and symptoms, according to Ali KM and Sathiyasekaran BWC, ranging from 3 to 6 %b only, but we think real situation is much worse. Postural stress due to inadeqauate workstation ergonomics (inappropriate location of monitor, keyboard or mouse) discussed as cause of all mentioned technological diseases in this text ( Figure 7 ). Aydan Oral et al. Had written paper about Evidence Based Physical Medicine and Rehabilitation strategies for patients with cervical radiculopathy due to disc herniation. They reported that neck pain affected 4,82% of the world population in 2010, ranks second after low back pain among musculoskeletal disorders as one of the leading causes of years lived with disability, with contribution of 33,6 million years ( 26 ). Physical medicine and rehabilitation interventions in radicular neck pain and their evidence based are: a) educational interventions; b) exercise; c) workplace interventions/ergonomics; d) phyasical agents (TENS, therapeutic ultrasound, low-level laser therapy) pulsed electromagnetic field therapy, non-invasive brain stimulation techniques, etc); e) injection therapy (epidural steroids, botulinum toxin, ozone); f) cervical collars; g) traction; manual therapies (massage, manipulation and mobilization (commonly used in the management of discogenic neck pain); complementary and alternative medicine treatments (acupuncture, herbal medicine, etc.). Much research efforts have been spent and several risk factors such as heavy lifting, lifestyle, psichosocial factors identified, but the etiology of technological diseases are still or not enough unclear. Recurrences and functional limitations can be minimized limitations with appropriate conservative management, including medications, physical therapy, exercise and patient education. But, these subgroup of developing chronic and disabling symptoms generating large social costs ( 26 ).

An external file that holds a picture, illustration, etc.
Object name is AIM-22-333-g007.jpg

Recommended proper position of the neck, torso, arms and legs when working at a computer

According to the Panel evidence-based clinical practice guidelines on musculoskeletal rehabilitation interventions the key points to clinicians are ( 23 ) ( Table 1 and ​ and2 2 ):

Summary grid of neck pain guidelines. *Adapted from the Philadelphia Panel Members and Ottawa Methods Group.2. A, benefit demonstrated; C, no benefit demonstrated; EMG, electromyographic; ID, insufficient or no data; TENS, transcutaneous electrical nerve stimulation

An external file that holds a picture, illustration, etc.
Object name is AIM-22-333-g008.jpg

Summary grid of shoulder pain guidelines. *Adapted from the Philadelphia Panel Members and Ottawa Methods Group.1A, benefit demonstrated; C, no benefit demonstrated; EMG, electromyographic; ID, insufficient or no data; TENS, transcutaneous electrical nerve stimulation.

An external file that holds a picture, illustration, etc.
Object name is AIM-22-333-g009.jpg

  • The Philadelphia Panel recommends continued normal activities for acute, uncomplicated low back pain and therapeutic exercise for chronic, subacute, and postsurgical low back pain.
  • The Philadelphia Panel also recommends transcutaneous electrical nerve stimulation and
  • exercise for knee osteoarthritis.
  • For chronic neck pain, the Philadelphia Panel recommends proprioceptive and thera-peutic exercise.
  • The Philadelphia Panel found evidence to sup-port the use of therapeutic ultrasound in thetreatment of calcific tendonitis of the shoulder.
  • The main difficulty in determining the effec-tiveness of rehabilitation interventions is the lack of well-designed, prospective, random-ized, controlled trials.

Acute neck pain is often associated with injury or accident, whereas chronic neck pain is related to repetitive injury. Neck pain is commonly managed with analgesics and rest, but referrals to rehabilitation are increasing. The Philadelphia Panel sought to improve the appropriate use of rehabilitation interventions for neck pain by providing evidence-based guidelines. A summary of the Panel's recommendations can be found in Table 2 .

Rehabilitation specialists offer several conservative interventions for the management of shoulder pain. There are few published guidelines for the management of shoulder pain.

8. CONCLUSION

Thanks to the high use of computers, resulting diseases of the modern era, known as the“Technological disease.” Under this term we mean the diseases caused by the harmful influence of the job in the first place, the working position in which it is involved excessive work for a computer, such as the banking sector, the health sector and many others who are directly or indirectly connected with the work on the computer and overuse keyboards and computer mice, which are in a number of cases of non-ergonomic, and inappropriate for a handful. Establishing the diagnosis of diseases of technology is an interdisciplinary process that requires special knowledge in medicine and related fields related to health and safety at work. Determining the causes and diagnosis of occupational diseases is carried out according to the criteria of modern medicine work.

First, we identify the clinical picture of the disease on the one hand and identification in the working process on the other side, and their immediate connections. Medical history is the gold standard, because without it, it would be possible to find information on working conditions and the duration and intensity of exposure to a particular hazard from the workplace. The intensity and length of exposure to harmful factor must be that level that is known and proven scientific research that can damage health. Prevention would involve, educate employees by computers to ensure better and more regular position of the spine and shoulder while working at the computer, as well as the use of stylish ergonomic mice in hand. Of course, adequate work breaks are required, in order to avoid fatigue and exhaustion syndrome, but today it is difficult to appreciate the extent and speed of work. No less important and efficient are exercises to strengthen the shoulder belt, as well as exercises for posture.

CONFLICT OF INTEREST: NONE DECLARED.

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Virtual Mouse using OpenCV

Abstract: This research introduces a novel method for controlling mouse movement with a real-time camera. Adding more buttons or repositioning the mouse's tracking ball are two common ways. Instead, we recommend that the hardware be redesigned. Our idea is to employ a camera and computer vision technologies to manage mouse tasks (clicking and scrolling), and we demonstrate how it can do all that existing mouse devices can. This project demonstrates how to construct a mouse control system.

Virtual Mouse using Hand Gestures

Brain-inspired spiking neural network controller for a neurorobotic whisker system.

It is common for animals to use self-generated movements to actively sense the surrounding environment. For instance, rodents rhythmically move their whiskers to explore the space close to their body. The mouse whisker system has become a standard model to study active sensing and sensorimotor integration through feedback loops. In this work, we developed a bioinspired spiking neural network model of the sensorimotor peripheral whisker system, modelling trigeminal ganglion, trigeminal nuclei, facial nuclei, and central pattern generator neuronal populations. This network was embedded in a virtual mouse robot, exploiting the Neurorobotics Platform, a simulation platform offering a virtual environment to develop and test robots driven by brain-inspired controllers. Eventually, the peripheral whisker system was properly connected to an adaptive cerebellar network controller. The whole system was able to drive active whisking with learning capability, matching neural correlates of behaviour experimentally recorded in mice.

Hand Gesture Recognition System as Virtual Mouse for HCI

Abstract: The technique of interaction between human and computer is evolving since the invention of computer technology. The mouse is one of the invention in HCI (human computer interaction) technology. Though wireless are Bluetooth mouse technology is invented still, that technology is not completely device free. A Bluetooth mouse has the requirement of battery power it requires extra power supply. Presence of extra devices in a mouse increases the difficulty level of more hardware components. The proposed mouse system is outside this limitation. This paper proposes a virtual mouse system using colored hand glove based on HCI using computer vision and hand gestures. Gestures captured with a webcam on processed with color segmentation, detection technique and feature extraction. The user will be allowed to control some of the computer cursor functions with a colored glove on the hand. Primarily, a user can perform with their fingers, scrolling up or down using their hands in different gestures. This system captures frames using a webcam or built-in cam it is based on the camera quality. So the usage of colored glove mouse system eliminates device dependency in order to use a mouse. Keywords: HCI(human computer interaction), colored hand glove , gestures

Virtual Mouse Control Using Finger Action

Operating virtual keyboard and mouse using hand gestures.

This project promotes an approach for the Human Computer Interaction (HCI) where cursor movement can be controlled using a real-time camera, it is an alternative to the current methods including manual input of buttons or changing the positions of a physical computer mouse. Instead, it utilizes a camera and computer vision technology to control various mouse events and is capable of performing every task that the physical computer mouse can. The Virtual Mouse color recognition program will constantly acquiring real-time images where the images will undergone a series of filtration and conversion. Whenever the process is complete, the program will apply the image processing technique to obtain the coordinates of the targeted colors position from the converted frames. After that, it will proceed to compare the existing colors within the frames with a list of color combinations, where different combinations consists of different mouse functions. If the current colors combination found a match, the program will execute the mouse function, which will be translated into an actual mouse function to the users' machine.

Implementing a Real Time Virtual Mouse System and Fingertip Detection based on Artificial Intelligence

Artificial intelligence refers to the simulation of human intelligence in computers that have been trained to think and act like humans. It is a broad branch of computer science devoted to the creation of intelligent machines capable of doing activities that would normally need human intelligence. Despite the fact that Artificial intelligence is a heterogeneous science with several techniques, developments in machine learning and deep learning are driving a paradigm shift in practically every business. Human-computer interaction requires the identification of hand gestures utilizing vision-based technology. The keyboard and mouse have grown more significant in human-computer interaction in recent decades. This involves the progression of touch technology over buttons, as well as a variety of other gesture control modalities. A normal camera may be used to construct a hand tracking-based virtual mouse application. We combine camera and computer vision technologies, such as finger- tip identification and gesture recognition, into the proposed system to handle mouse operations (volume control, right click, left click), and show how it can execute all that existing mouse devices can.

Development of CNN-based Virtual Mouse

The technique of building a process of interaction between human and computer is evolving since the invention of technology. The mouse is a superb invention in HCI (Human-Computer Interaction) technology. Though wireless mouse technology is invented still, that technology isn't completely device free. A Bluetooth mouse has the need of battery power and connecting dongle. The proposed mouse system is beyond this limitation. This paper proposes a virtual mouse system supported HCI using computer vision and hand gestures. Gestures captured with a built-in camera or webcam and processed by a Convolutional Neural Network Model for classification among the desired mouse operations. The users are going to be allowed to regulate a number of the pc cursor functions with their hand gestures. Primarily, a user can perform left clicks, right clicks, and double clicks, scrolling up or down using their hand in several gestures. This technique captures frames employing a webcam or built-in cam and processes the frames to make them track-able and then recognizes different gestures made by users and perform the mouse functions. Therefore the proposed mouse system eliminates device dependency so as to use a mouse.

There is no mouse: using a virtual mouse to generate training data for video-based pose estimation

Hand gesture based virtual mouse, export citation format, share document.

research paper about computer mouse

Historic Firsts:   The Mouse 0

Doug Engelbart invented the computer mouse in the early 1960s in his research lab at Stanford Research Institute (now SRI International). The first prototype – a one-button mouse in a wooden shell on wheels – was built in 1964 to test the concept. 1a

The first mouse now on exhibit at the Smithsonian! Click here for details .

Based on results of his landmark study on ' Augmenting the Human Intellect ,' Engelbart had received modest funding to evaluate the speed and efficiency of various devices for pointing on a display screen, like the joy stick, including a few his team rigged up and threw into the mix, like the one they called a "mouse." Which pointing device scored the highest? How was it built and tested? What inspired all this anyway? Read on! And don't miss Check it Out below for original footage, photos, timelines, documents, fun facts, and more. 1b

A patent application for the mouse was filed in 1967, and US Patent 3,541,541 was awarded in 1970 under the descriptive title "X-Y position indicator for a display system." 1c

Although many impressive innovations for interacting with computers have followed in the last 50 years since its invention, the mouse remains to this day the most efficient hands on pointing device available for speed and accuracy. 11dc

The First Mouse 2

Since 1951 Doug had envisioned intellectual workers sitting at high-performance interactive display workstations, accessing a vast online information space in which to collaborate on important problems. When pondering the question of pointing devices in 1961, he was in the midst of an in-depth study of how teams and organizations might become much more effective in solving important problems. In 1962 he published his findings in " Augmenting Human Intellect: A Conceptual Framework ," which in 1963 garnered him some modest funding from ARPA to begin to hire a very small research team, and set up a basic lab with computer resources, teletypes, and finally, a display workstation.

By now there were several off-the-shelf solutions for moving a cursor and selecting something on a display screen, but no good data about which would be most efficient to meet Engelbart's "high-performance" requirement. He applied for and was awarded a small grant from NASA to explore that question.

Check It Out 3

Witness the World's Debut - watch Doug introduce the mouse , and watch the mouse in action , footage selected from Doug's newly re-mastered 1968 'Mother of All Demos' - and now using your own mouse or alternative, you can 'test drive' the demo interactively , or watch just the Demo Highlights 3a

Watch Doug tell the story in his Designing Interactions interview with IDEO's Bill Mogridge [ book ], in his 2002 Oral History interview with NY Times' John Markoff for the Computer History Museum, and in his historic talk " The Augmented Knowledge Workshop " presented at the 1986 Conference on the History of the Personal Workstation. 3b

On Exhibit: visit virtual and actual museum exhibits showcasing his innovations at the Smithsonian Museum, the Computer History Museum, and more. Visit On Exhibit and Special Collections by Institution for details. 3c

Watch Doug telling the story of how he invented the mouse in Logitech 's 2004 interview. 3d

Watch "The Computer Mouse" video short on how the mouse changed lives and enabled the personal computing industry to take off and thrive. 3d

Explore the Stanford University MouseSite where you will find images of the first mouse , the US Patent on the Mouse , historic photos from the lab, and much more. 3e

See SRI's Timeline on Innovation: Computer Mouse and Interactive Computing , MIT Press Designing Interactions: Doug Engelbart , Macworld's mouse history timeline , PC Advisor's 40th anniversary timeline , and our History in Pix photo gallery. 3f

Check out the online Exhibit on the Mouse and Keyset at the Computer History Museum , as well as press coverage of their 2001 event " Early Computer Mouse Encounters ". 3g

Logitech celebrates "ONE BILLION MICE SOLD!" making headlines in 2008. See Logitech's press release , blog post with links to press, and their billionth mouse celebration page with links to press kits filled with fun facts and timelines. The event coincided with our 40th anniversary celebration of Doug's landmark demo, titled "Engelbart and the Dawn of Interactive Computing". Enjoy the following timeline from Logitech's press kit marking their 2008 celebrations. 3h

research paper about computer mouse

The Mouse Wins 4

In 1965 Engelbart's team published the final report of their study evaluating the efficiency of the various screen-selection techniques. They had pitted the mouse against a handful of other devices, some off the shelf, some of their own making (see Mouse Alternatives below). The mouse won hands down, and was thus included as standard equipment in their research moving forward (see Screen-Selection Experiments below for links to key reports and papers detailing these experiments ). In 1967, SRI filed for the patent on the mouse , under the more formal name of "x,y position indicator for a display system," and the patent was awarded in 1970. 4a

Enter, the Keyset 3b

Enter, the Keyset: To further increase efficiency, Engelbart's team thought to offer a companion to the mouse – a device for the left hand to enter commands or text while the right hand was busy pointing and clicking (shown above). After trying out several variations, they settled on a telegraph-style " keyset " with five piano-like keys. This keyset also became standard equipment in the lab (pictured below). Both devices were introduced to the public in Engelbart's 1968 demonstration, now known as the " Mother of All Demos " (see Check It Out below for links to selected video footage of the debut, historic photos, and more). 4b

In Doug's Words: 4c

The mouse we built for the [1968] show was an early prototype that had three buttons. We turned it around so the tail came out the top. We started with it going the other direction, but the cord got tangled when you moved your arm. I first started making notes for the mouse in '61. At the time, the popular device for pointing on the screen was a light pen, which had come out of the radar program during the war. It was the standard way to navigate, but I didn't think it was quite right. Two or three years later, we tested all the pointing gadgets available to see which was the best. Aside from the light pen there was the tracking ball and a slider on a pivot. I also wanted to try this mouse idea, so Bill English went off and built it. We set up our experiments and the mouse won in every category, even though it had never been used before. It was faster, and with it people made fewer mistakes. Five or six of us were involved in these tests, but no one can remember who started calling it a mouse. I'm surprised the name stuck. We also did a lot of experiments to see how many buttons the mouse should have. We tried as many as five. We settled on three. That's all we could fit. Now the three-button mouse has become standard, except for the Mac. Doug Engelbart in The Click Heard Round The World , by Ken Jordan, WIRED 2004

Mouse Alternatives 5

Engelbart and his team tested a half dozen pointing devices for speed and accuracy. These included the mouse, and a knee apparatus (pictured below, right), both created in-house, along with several off the shelf devices such as DEC's Grafacon (pictured below, center, modified for testing purposes), a joy stick, and a light pen. See Screen-Selection Experiments below for links to more details and photos. They also experimented with a foot pedal device as well as a head mounted device, neither of which made it into the final tests. 5a

A small piece of a large vision 6

In the 1950s, Doug Engelbart set his sights on a lofty goal -- to develop dramatically better ways to support intellectual workers around the globe in the daunting task of finding solutions to larger and larger problems with greater speed and effectiveness than ever before imagined. His goal was to revolutionize the way we work together on such tasks. He saw computers, at the time used primarily for number crunching, as a new medium for advancing the state of the art in collaborative knowledge work. Building on technology available at the time, his research agenda required that his team push the envelope on all fronts: they had to expand the boundaries of display technology and interactive computing and human-computer interface , help launch network computing , and invent hypermedia , groupware , knowledge management , digital libraries, computer supported software engineering , client-server architecture, the mouse, etc. on the technical front, as well as pushing the frontiers in process reengineering and continuous improvement, including inventing entirely new organizational concepts and methodologies on the human front. Engelbart even invented his own innovation strategy for accelerating the rate and scale of innovation in his lab which, by the way, proved very effective. His seminal work garnered many awards , and sparked a revolution that blossomed into the Information Age and the Internet. But as yet we have only scratched the surface of the true potential Engelbart envisioned for dramatically boosting our collective IQ in the service of humankind's greatest challenges. Check out his Call to Action and the Engelbart Academy to learn about his prescient message for the future. 6a

Genesis of the mouse: 7

Doug's Early Vision: From the introduction of his Augmenting human intellect: A conceptual framework (1962): 7a

Let us consider an augmented architect at work. He sits at a working station that has a visual display screen some three feet on a side; this is his working surface, and is controlled by a computer (his "clerk") with which he can communicate by means of a small keyboard and various other devices. 7a1 He is designing a building. He has already dreamed up several basic layouts and structural forms, and is trying them out on the screen. The surveying data for the layout he is working on now have already been entered, and he has just coaxed the clerk to show him a perspective view of the steep hillside building site with the roadway above, symbolic representations of the various trees that are to remain on the lot, and the service tie points for the different utilities. The view occupies the left two-thirds of the screen. With a pointer he indicates two points of interest, moves his left hand rapidly over the keyboard, and the distance and elevation between the points indicated appear on the right-hand third of the screen. 7a2 Doug Engelbart, 1962 [ Source ]

From As We May Think by Vannevar Bush, 1945 (quoted by Engelbart in Augmenting Human Intellect ): 7b

"Consider a future device for individual use, which is a sort of mechanized private file and library. It needs a name, and to coin one at random, "memex" will do. A memex is a device in which an individual stores all his books, records, and communications, and which is mechanized so that it may be consulted with exceeding speed and flexibility. It is an enlarged intimate supplement to his memory. 7b1 "It consists of a desk, and while it can presumably be operated from a distance, it is primarily the piece of furniture at which he works. On the top are slanting translucent screens, on which material can be projected for convenient reading. There is a keyboard, and sets of buttons and levers. Otherwise it looks like an ordinary desk. 7b2 Vannevar Bush, 1945 [ Source ]

Read more... and see how Engelbart was influenced by Vannevar Bush. 7b3

Debunking the Xerox PARC Mouse Myth 8

In the early 1970s, the mouse migrated from Doug's lab at SRI to Xerox PARC (along with some of his team), and later to Apple when Steve Jobs visited Xerox PARC, and beyond. One of the most common myths about the mouse is the mistaken belief that it was invented at Xerox PARC. Note that the first mouse was built in 1964, the patent for the mouse was filed in 1967 , and demonstrated to an audience of over a thousand in 1968, by which time production models were in operational use throughout Doug's lab. Xerox PARC did not exist until 1970. 8a

"Your article on Xerox noted that its research center Xerox PARC was responsible for the computer mouse. Douglas C. Engelbart and his team at SRI International (which was then known as Stanford Research Institute) invented the mouse and created the foundations for personal computing. The patent for the mouse was filed in 1967, three years before Xerox PARC was established in 1981 ." 8a1

Explore the Web 9a

  • Visit Historic Firsts - for more of Doug Engelbart's many groundbreaking firsts; related to the Mouse, see especially Interactive Computing and The Keyset . 9a1
  • MouseSite - the definitive website on the Mouse hosted by Stanford University, especially their Photos of the First Mouse page. They also curate video of the 1968 demo and other significant archives from Doug Engelbart's work. 9a2
  • See the SRI Timeline on Innovation: Personal Computing + the Mouse , the SRI press release Engelbart and the Dawn of Interactive Computing (excellent overview), as well as our event resources page for Engelbart and the Dawn of Interactive Computing 9a3
  • Visit the online exhibit on The Mouse at the Computer History Museum or visit their museum in Mt. View, CA; check out their Early Computer Mouse Encounters event at the Computer History Museum, Oct 17, 2001 9a4
  • See the Mouse Timeline in The computer mouse turns 40 - a great article by Benj Edwards, Macworld, Dec 9, 2008 on the history of the Mouse. 9a5
  • Visit Logitech's Billionth Mouse site - see the genesis of the mouse. 9a6
  • Planimeter: Planimeters are often used by surveyors, foresters, geologists, geographers, engineers, and architects to measure areas on maps of any kind and scale, as well as plans, blueprints, or any scale drawing or plan. (source: Ben Meadows ). See How Planimeters Are Used for some great visuals (thanks to Dr. Robert Foote at Wabash College), and this photo of geographers using planimeter for the 1940 census (thanks to the National Archives). See also Wikipedia's more complete Planimeter article with links to other resources. 9a7

From Doug's Lab 9b

  • Screen-Selection Experiments: Display-Selection Techniques for Text Manipulation , William K. English, Douglas C. Engelbart and Melvyn L. Berman, March 1967. This paper describes an experimental study into the relative merits of different CRT display-selection devices as used within a real-time, computer-display, text-manipulation system in use at Stanford Research Institute. The mouse was tested against other devices and found to be the most accurate and efficient. See also the 1965 Report and the 1966 Quarterly Report detailing their screen-selection experiments. 9b1
  • Augmenting Human Intellect: A Conceptual Framework , Douglas C. Engelbart. 1962. See for example how he envisioned an architect might work interactively with a computer in 1962 in the Introduction's summary of Section IV (quoted at right). 9b2
  • Doug Engelbart - A Lifetime Pursuit , a short biographical sketch by Christina Engelbart describes the larger context of this early work. 9b3

Book cover

International Conference on Intelligent Human Systems Integration

IHSI 2019: Intelligent Human Systems Integration 2019 pp 909–913 Cite as

Enhancing Cursor Control Using Eye Movements

  • Muhammad Sohaib Shakir 16 ,
  • Amina Akhtar 17 ,
  • Habiba Kulsum 18 ,
  • Anam Mukhtar 16 &
  • Iqra Saleem 16  
  • Conference paper
  • First Online: 06 January 2019

2710 Accesses

Part of the Advances in Intelligent Systems and Computing book series (AISC,volume 903)

This paper is about different techniques how we can control our cursor on the computer system without touching the mouse (Hardware). This is possible through the iris of instead of mouse or keyboard. Research that is described in this paper has an aim to reduce the complexities and difficulties that are involved the detection and tracking of the iris for the persons to interact with the computer without touching the mouse or keyboard. The research paper defines operations performed on the images of high resolution of the subject’s (Human) eye to compute/calculate the eye movement/tracking and patterns of iris in left & right direction. The detection takes place according to the center of the eye (Origin of the eye). The calculated/computed data from the position of the iris can be used in the technique of application based processing. The Cursor Control Using Iris research has various applications in the field of Human-Computer Interaction (HCI) like mouse cursor control. In this paper, there is a discussion about eye tracking using eyeball mouse.

  • Eye tracking patterns
  • Eye-blinking computations
  • Human computer interaction (HCI)
  • Eye movement with respect to center of eye (Center of eye is as origin from where the tracking starts)

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MARGI SADASHIV NARAYAN, 2WARANG PRAVIN RAGHOJI: Viola-jones Algorithm and Houghman Circle Detection Algorithm

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Department of Information Technology, University of Lahore, Gujrat, Pakistan

Muhammad Sohaib Shakir, Anam Mukhtar & Iqra Saleem

Department of Computer Science, University of Gujrat, Gujrat, Pakistan

Amina Akhtar

Department of Computer Science, The Superior College Lahore, Gujrat, Pakistan

Habiba Kulsum

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Shakir, M.S., Akhtar, A., Kulsum, H., Mukhtar, A., Saleem, I. (2019). Enhancing Cursor Control Using Eye Movements. In: Karwowski, W., Ahram, T. (eds) Intelligent Human Systems Integration 2019. IHSI 2019. Advances in Intelligent Systems and Computing, vol 903. Springer, Cham. https://doi.org/10.1007/978-3-030-11051-2_139

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