Design Features of Alternative Computer Keyboards: A Review of Experimental Data

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Abstract
Design of computer keyboards no longer is limited to the flat keyboards that are typically shipped with personal computers. Keyboards now exist that are split into halves and these halves can be slanted away from each other (creating a triangle between the halves), sloped downward toward the visual display terminal, tilted upward like a tent, or simply separated. These design features are intended to alleviate discomfort and possible musculoskeletal disorders that have been suggested to be associated with the extensive use of conventional computer keyboards. The geometry of conventional keyboards requires the wrists to be in 10 degrees to 15 degrees of ulnar deviation and 20 degrees of extension and the forearms to be nearly fully pronated while typing. A review of the available experimental data collected on 10-digit touch typists indicates that (1) keyboards with a slant angle (half of the opening angle) of 10 degrees to 12.5 degrees or keyboards with halves separated to approximately shoulder width are both effective in placing the wrist in near neutral (0 degree) ulnar/radial deviation when typing, (2) wrist extension can be reduced to near neutral (0 degrees) when a keyboard with a negative slope of 7.5 degrees is used, contingent on the wrist rest also sloping with the keyboard, and (3) tilting the keyboard halves 20 degrees to 30 degrees is effective in reducing forearm pronation to approximately 45 degrees. These studies also indicate that experienced 10-digit touch typists readily adapt (within 10 minutes) to these individual alternative keyboard features, and can type with approximately the same speed and accuracy as with the conventional keyboard. While placing the wrist and forearm in a more neutral position could, in theory, reduce the incidence of musculoskeletal disorders, randomized controlled trials are necessary before strong recommendations can be made on the effectiveness of alternative keyboards for the prevention and/or treatment of musculoskeletal disorders. In the absence of these randomized controlled trials, the information in this article provides preliminary guidance to clinicians in their evaluation of computer keyboards and workstations and their recommendations to patients.