"There is no Cure for Muscular Skeletal Injuries,
                         Only BODY Maintenance"
                                                     Kate Montgomery

 
Sportstouch
Article
 
Computer Health For Children
 
Ergonomics and Body Maintenance
A straight forward manual that offers a nonsurgical approach solution to  upper body musculoskeletal disorders.
 
Instructional Manual for Instructors and Children, Ages 5-17 Workstation setup  
Preparation for using the computer
 
Correct posture
Body maintenance
Preparation of the body, rest periods, 5 minute restoration  ritual of the body, completion of work  
 
Foreword  
 
Technology and the 21st century are rushing at us with supersonic speed. Computers are now a part of everyone's life.  Unfortunately we are coming to depend on them for almost everything.  The epidemic of musculoskeletal injuries that has crippled the working force of the 20th century is on its way to affecting future generations.  Our children are our future.  If they are not shown how to setup and prepare a workstation and learn how to take care of their bodies, they too, will become a statistic in the debilitating injuries of carpal tunnel syndrome, tendinitis of the elbow, shoulder, neck and back disorders.  Not to mention possible vision and hearing problems.  Our children are growing and are at risk of not making it into the workforce due to improper education in this area.  
 
This manual is designed to instruct children and young adults, ages 7-17 along with help from teachers and parents in how to prepare the workstation prior to beginning work, and secondly, how to manage and maintain the body to avoid musculoskeletal injury.  
 
My true hope is this epidemic will cease to exist in the 21st century due to the willingness of the alleopathic medical profession to open its eyes to the use of complimentary therapies.  Surgery should not be an option for our children.  
 
Understanding Ergonomics  and the Workstation Setup  
 
This chapter will address correct workstation setup and preparation.  
 
Part I.  Preparation of the workstation
 
Graphic of setup of workstation
 
All equipment should be adjusted to fit the individuals body comfortably to enable them to sustain an 2-8 hour working day.  Each child in accordance with their height and size should have equipment to fit their body comfortably, no matter how long they sit at the computer.  Dimensions of the workstation layout will vary due to the height, arm reach, leg length and general size of the child.  
 
There are several factors to be looked at in the workstation setup.
 
1. Equipment that supports the body comfortably.
2. Layout of the workstation
3. Size of the workstation area
4. The workstation should be able to be adjustable for each child/young adult prior to using the workstation.  The correct workstation preparation and the environment is especially important for mental concentration and physical relaxation to maximize work efficiency.  
 
1. Proper Equipment to Support the Human Body
 
Postural effects within the workstation area.  
 
1. Reach limits:  
 
The workstation design should allow the individual to face forward, whether standing or sitting.  Reaching for objects should be within the normal reach and without straining or twisting to retrieve an object.
 
Rules to go by:  
 
1. Avoid reaching behind you and twisting the spine backward.
2. Avoid reaching across the body with one or two hands, twisting forward.
3. Avoid overreach distances.  Place objects within arms length.
4. Keep frequent, fast and forceful movements within limits.
5. Allow for efficient movement.
 
2. Height limitations: Chair and Desk  
 
Optimal heights for a chair and desk depend on the individuals proportions.  A work area that is too high will create stressful shoulder and arm positions.  An area that is too low will create stressful bending of the neck and trunk of the body.  In children these measurements will depend on the age of the child and proportions.  A rule of thumb is to be able to maintain a 90 degree or less for stability of the joints of the elbows and knees.  For the knees, it is good to allow a slight relaxation of this joint to allow for increased circulation in the legs.
 
Correct posture and support of the body is essential. Sitting upright, shoulders back and down, head sitting squarely on the shoulders, lower back supported and feet flat of the floor or on a foot stool.
 
Chairs:  
 
Chairs should accommodate  each individual and should be adjusted to fit that persons body.  Each chair should have safe and easy control knobs and it should be obvious to the individual.   Where there are many users, taking the time to adjust the chair can mean hours of comfortable work.  
 
Adjusting the chair:  To be adjusted are the seat, seat pan, arm rests, backrest, and footrest.  
 
1. Adjust the seat of the chair to the proper working height, where your feet sit flat on the floor and your knees are approx. 2-4 inches below the desk height.
2.  The seat pan should be large enough or small enough to fit the individual.
3. Not too deep that the backrest cannot be used.
4. Not too long, that it puts pressure on the back of the knees or calves to inhibit circulation
5. It should be a rounded front edge to minimize pressure on the back of the  thighs;
6. The fabric of the seat pan should be non-slip, breathable with sufficient padding to provide comfort.  
 
Backrest:  
 
It should fit the contour of the individuals back to maintain the natural curvature of the spine.  It should provide firm support for the lower and middle back and with sufficient padding for comfort. There should be an adjustable knob for the lower back.  If not, place a medium to firm pillow in the curve of the low back. This will help to eliminate back fatigue.  
 
Armrest:  
 
Armrest are recommended for all types of chairs unless they get in the way of the work.
1.They should be padded, and be wide enough  for elbow comfort.
2. The height and distance apart should provide comfortable support allowing for easy movement and correct positioning of the chair.
3. The armrests should not be too wide to not be used
 
Footrest or support stool:  
 
A footrest should be provided to help maintain the support and angle of the legs.  For children this is a must.  The footrest should have complete contact with the floor and a minimum base of 68 cm.  It should not be able to roll and if castors, they should be of the locking type.  
 
Footrests  are used to bring the upper legs parallel to the floor.  Separate footrests are preferred because they are more stable and do not require a backward angle of the lower leg.
 
4. Chairs with wheels or castors are best. They should not restrict movement and are best to avoid twisting movements  and awkward postures of the body.  They decrease fatigue from having to get up or down. The chair should be designed to protect against tipping over or slipping.
 
Chair heights and support for the body
 
Developing early on correct preparation at the workstation can save hours of inefficient and unproductive time due to musculoskeletal discomfort and pain.  
 
Part II.  Preparation for the body before, during and after work
 
CTS book.  1-12 steps for children.
 
Range of motion exercises for the arms and hands.  CTS book  
 
Visual display terminals and monitors.
 
Understanding the work-rest cycles in an eight hour work day.  
 
In order to avoid stain and tension in the muscles, one must first understand it is necessary to stop and take several  rest breaks throughout the work day.  The lack of productivity is enhanced by the amount of fatigue one starts to feel.  There is an increase risk in musculoskeletal injury.  
 
The work rate and amount of risk varies with the amount of continuous and repetitive work the individual performs.   Each person is unique to their own body and some may need longer periods of rest to recover. Having a flexible production system will help to accommodate for individual differences in physical tolerance.
 
Rules for work rate are:
 
For every hour, the individual should have  5 minutes rest period - this time should be spent correcting posture, performing techniques to help align and stretch the body.  At lunch time, the 30 minutes allowed should be spent with personal issues but preparing the body to work into the second half of the day.

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