Work 18 (2002) 67–73 67

IOS Press

The effectiveness of ergonomic intervention

in the classroom
Janette Shinn, Kari-Ann Romaine ∗, Tara Casimano and Karen Jacobs
Touro College, School of Health Sciences, Department of Occupational Therapy, Bayshore, NY, USA

Received 16 November 2000

Accepted 29 January 2001

Abstract: Objective: To see if an in-service on proper body mechanics and ergonomics for computer workstation usage can
increase a student’s knowledge regarding these areas.
Study design: This was a quasi-experimental design using a questionnaire. Subjects included seventy-three male and forty-four
female sixth-grade students enrolled in a word processing class at a New York Middle School. A non-standardized demographic
and ergonomic based questionnaire was administered before and after an in-service. An environmental checklist was used to
formulate a percentage of ergonomically correct computer workstations.
Results: There was a statistically significant difference between pre and post-test scores, indicating that learning took place.
Pre-test scores suggest that there exists a need for ergonomic education in classrooms. Results from an environmental checklist
support the need for revision of computer workstations in classrooms.
Conclusion: Ergonomic education is one way to help students to reduce their risks of developing musculoskeletal injury in a
classroom environment that impedes correct positioning.

1. Introduction posturing can entrap peripheral nerves, create localized

1.1. Rationale
Students spend numerous hours per week utiliz-
ing computers that are not properly designed to ac-
commodate for their varying anthropometric measure-
ments [8]. This often creates a mismatch between the
size of the child and the computer equipment he or she
is using. An example includes the size of the mouse in
relation to a child’s palm and fingers. Also, the height
of the monitor in relation to a child’s stature while
seated.
Additionally, many families have invested in home
computers in which the workstations are designed for
the adult in the household. As a result children are
assuming unnatural or awkward postures. Awkward
∗ Address for correspondence: Kari-Ann Romaine, 19 Forest Ln.,
Coram, NY 11727, USA. Tel.: +1 631 698 6136; Fax: +1 631 698
2177.
muscle fatigue and increased susceptibility of muscles
of the upper extremity, neck and back to small mi-
crotears and inflammatory changes. The end result of
affected muscles and tendons may be pain and impaired
function [7].
Continuous hours spent at a computer workstation
that is not designed for that individual places him or
her at risk for developing cumulative trauma disorders
(CTD’s) in the back, neck, shoulder, hands and
wrists [7]. The risk for injury increases with each con-
secutive hour spent at the computer workstation [3].
Examples of CTD’s include tendinitis, nerve compres-
sion syndromes and myofascial pain [5]. These can
occur when there is an applied force to the same muscle
or muscle group causing an inflammatory response in
a tendon, muscle or nerve [5].
A possible solution to minimizing the occurrence
of CTD’s in children is preventative education. Er-
gonomic intervention within the computer classroom
may be able to help prevent poor positioning from be-
coming habitual in the future. Occupational therapists

1051-9815/02/$8.00  2002 – IOS Press. All rights reserved

68 J. Shinn et al. / The effectiveness of ergonomic intervention in the classroom
can educate both teachers and students regarding proper
body mechanics when utilizing a computer. This will
enable students to take an active role in protecting them-
selves from CTD’s. Additionally, future research in-
vestigating the impact that CTD’s have upon children
will help to establish a need for ergonomic intervention
within the classroom. *****
1.2. Hypothesis
Students will show increased knowledge of proper
body mechanics and ergonomics for computer work-
station usage, following an in-service regarding these
areas.
– How ergonomically correct are the computer
workstations that students are currently utilizing?
– Is there a need for preventative education regarding
ergonomics and computer usage, as measured by
baseline pre-test scores?
2. Materials and methods
2.1. Instrument design
The design for this study was a convenience sam-
ple utilizing a non-standardized questionnaire. Sub-
jects were given a questionnaire consisting of 17 demo-
graphic and positioning questions. This questionnaire
was administered to subjects before and after an educa-
tional in-service. The content of the in-service included
pre and post questionnaire scores that were compared to
determine whether learning took place throughout the
ergonomic presentation. The demographic questions
were open ended, yes/no and close ended option ques-
tions. The testing questions were close-ended encom-
passing true/false, yes/no, and multiple-choice options.
The environmental checklist consisted of close-ended
yes/no options. Categories on this checklist encom-
passed separate components of the computer worksta-
tion. Yes/no answers were tabulated in order to formu-
late a percentage of ergonomically correct equipment.
2.2. Procedure
The study was performed at a New York middle
school. Data was collected February 7th through the
18th of the year 2000 in three designated computer
rooms within the school. Nine identical and separate
educational in-services were performed during various
class periods between the times of 8am and 2pm on
two separate days, five in-services the first day and
four the second day. Each in-service lasted for approx-
imately 30 minutes. Approximately 24–28 students
were present per class for a total of 117 subjects, 73
male and 44 female.
Questionnaires were distributed to all subjects’ seven
days prior to the in-service in order to achieve a base-
line. Subjects were instructed to answer all ques-
tions honestly and to the best of their ability. Upon
completion each questionnaire was retrieved and seven
days later an in-service was implemented. The in-
service consisted of a lecture and demonstration re-
garding proper seat height and positioning, position-
ing of keyboard and mouse, height and adjustment of
VDT (video display terminal), and techniques to re-
duce glare. All demonstrations for proper position-
ing were performed on classroom furniture. Adaptive
techniques were also demonstrated, such as utilization
of textbooks to adjust height of VDT or provide stable
foot support. Additionally, the importance of proper
stretching techniques and rest periods was provided to
students through demonstration and handouts. Directly
following the in-service a second questionnaire, identi-
cal to the original was distributed. Performances on pre
and post questionnaires were compared to determine
the effectiveness of the in-service.
Following the in-service each of the three computer
rooms present at the Middle School, were evaluated
through observation. An ergonomic checklist was de-
veloped as a guide for evaluation and utilized during
after school hours. Neither teacher nor students were
present within the classroom. As a result, evaluation
of all computer workstations was performed with no
interference or distraction from outside sources.
The ergonomic checklist provided a breakdown of
each computer workstation into six categories; table-
top, chair, VDT, keyboard, mouse, and lighting. All
workstations were inspected to determine if each of
the components listed in Appendix 2, were present. If
present, a check was placed next to the correspond-
ing component on the checklist to develop a percent-
age of ergonomically correct workstations. This per-
centage was obtained by dividing the total number of
workstations in all three classrooms by the number of
ergonomically correct workstations.
2.3. Variables under investigation
Variables obtained from subjects included: age, gen-
der, hours of computer use per day, breaks initiated
during computer use, and other activities performed si-
 J. Shinn et al. / The effectiveness of ergonomic intervention in the classroom 69

Table 1
Number and percent of male/female and 11 y.o./12 y.o./13 y.o.
3. Results
N % N %
Tables 1 and 2 list various statistics gathered through
Gender Male 73 62.4
Female 44 37.6
the pre and post-tests and surveys that were distributed
Age 11 84 71.8 to the sixth grade students. The mean for total hours
(years) 12 32 27.4 of computer use per day was 1.6 hours. The number
13 1 0.9 of students who utilize a computer on a daily basis for
Total 117 100 117 100
1–2 hours is 63. Eighty percent of students take breaks
while using a computer and take them once every hour
Table 2 at the computer. The percent of students who do not
Number and percent of hours spent on the computer
take breaks while using a computer is 20.5%. Those
Hours on comp N % students who take breaks on the average take them for
1–2 63 54.8 8.9 minutes. Sixty-two percent of students also practice
3–4 37 32.2
5–6 9 7.8
other activities, such as watching television, listening
>6 6 5.2 to music, or doing homework while on the computer.
Total 115 100 Students who do not adjust the height of their computer
chair at school or at home are 58%.
multaneously while using the computer. Variables un- It is important to note that the variation of N in Ta-
der investigation for the ergonomic checklist include; bles 1–4 is due to empty data cells. A small percent-
adjustable seating, VDT, keyboard and table top, seat- age of students omitted questions on the survey. Stu-
ing upholstery and mobility, screen clarity along with dents who were absent for either the pre-test or post-test
adjustable contrast and brightness, presence of wrist were omitted altogether from the study. Those students
rests, document holders, and keyboard tray, position omitted represents 24 subjects.
of mouse, ample leg room, light source, reflective sur- There is a statistically significant difference between
faces, and set-up of environment. pre and post-test scores (p = 0.001). The t-test values
for the pre and post-test are t = 0.259 and t = −1.056,
respectively. On average, the pre-test scores were 6.3
2.4. Subjects out of a possible 11 and the post-test scores were 10.0
out of a possible 11. This demonstrates a statistically
Subjects of this research project were sixth graders significant increase in test scores.
at a New York Middle School.
3.1. Ergonomic checklist
2.5. Data tabulation
Results of the ergonomic checklist were formulated
into percentages. It is important to note that some of
Scores obtained from the pre and post questionnaire the variables from each category were not mentioned
make up variables X1 and X2 respectively. Descrip- because they were not applicable to the setting. For
tive statistics and two tailed t-tests were utilized in or- example, due to the fact that there were no adjustable
der to determine statistical significance. This shows chairs within the classroom, the variable of five star
whether learning took place following the educational casters was not applicable. Additionally, the 5–10 de-
in-service. gree seat to back angle was a variable that was not
An ergonomic environmental checklist provided data applicable due to the fixed 90-degree angle of all the
on the number of ergonomically correct computer chairs.
workstations. This number was then converted into Room #1 had 24 Apple IIgs computers, room #2 had
a percentage that was compared to the total number 25 IBM computers and room#3 has 30 IBM computers
of computers currently utilized at the New York Mid- (N = 79). There were no adjustable tabletops in any
dle School. This percentage will help determine the of the three computer rooms. In the three rooms there
need for renovation of computer workstations within were also no adjustable chairs, but all workstations
the classroom. Appropriate recommendations for er- provided ample legroom.
gonomic renovation can be reported to school admin- Out of the 79 VDT’s present, 69.6% were angle ad-
istrators for future use. justable and swiveled from side to side. These VDT’s
70 J. Shinn et al. / The effectiveness of ergonomic intervention in the classroom
have 14-inch viewable screens. The remaining 30.4%
were not adjustable and have 12-inch viewable screens.
Of the VDT’s, however, 100% had adjustable screen
contrast and brightness. It was noted that all of the
screens had fingerprints and dust collected on the sur-
face. Moveable tabletop book holders were available
at 100% of the computer workstations.
Out of the 79 computer workstations all had detach-
able and moveable keyboards, but no wrist rests were
available. Keyboards with adjustable angle tilts encom-
passed 62% of the computer workstations. All key-
boards were located directly on the tabletop, so there
were no adjustable keyboard trays.
There were no computers in room #1 that had a
mouse (N = 24, 30.4%). The remaining computers in
room #2 and #3 did have a mouse (N = 55, 69.6%).
They were positioned on the tabletop adjacent to the
keyboard, allowing for manipulation through proper
body mechanics.
All three computer rooms had fluorescent overhead
lighting. There were no task lights at any of the work-
stations, but there were two windows in each room
(N = 6), which emitted natural light. Five of the six
windows had blinds, which were adjustable. There was
variation in the way all workstations were positioned
in relation to the windows. Those computers with win-
dows positioned from behind represented 35.4% of all
workstations. Those computers with windows posi-
tioned in front represented 63.3% of all workstations.
Computers with windows parallel represented 1.3% of
workstations.
4. Discussion
The hypothesis stated that students would increase
their knowledge base of proper body mechanics and
ergonomics for computer workstation usage, following
an in-service. The results indicate that there was a sta-
tistically significant increase in test scores following
the educational in-service. This supports the theory
that students can increase their knowledge base of er-
gonomics and computer use through education. Addi-
tionally, the pre-test scores suggest that there is a need
for preventative education regarding computer use for
school age children.
4.1. Result analysis
An environmental examination concluded that three
classrooms house a total of 79 computers. A closer
investigation revealed that each workstation was com-
prised of one or more components that were ergonom-
ically incorrect. Within the three classrooms there was
ample legroom, but an absence of adjustable chairs and
tables along with footrests and arm rests. However, a
majority of the VDT’s were adjustable in all planes.
It is suggested that the height and tilt of the VDT be
adjustable. This will allow the user to adjust the VDT
so that the screen is just below eye level [2]. Since
most of the VDT’s at the New York Middle School
allowed movement in all planes, aches and pains along
with stiffness and cramping of the back and neck may
be avoided [1].
The chairs that were currently available lacked cush-
ioning and upholstery, therefore, inhibit proper weight
distribution. Miller [4] supports the use of cushioning
to evenly distribute pressure under the ischial tuberosi-
ties in order to increase comfort while seated. The
chairs also have a fixed 90-degree seat to back angle.
According the Seymour [6] a seat to back angle of 90
degrees forces the lumbar spine into flexion, which can
lead to lower back pain. Seymour [6] recommends
100–110 degrees to prevent this.
Yeats [8] argues that it is difficult to encourage proper
posture early in life without the support of adjustable
chairs, desks and tables within the classroom.
Implementing adjustable chairs and tables within ev-
ery classroom is an expense that many school budgets
may not be able to match. However, without proper
seating accommodations efforts made from teachers to
encourage proper posture may be ineffective.
Results indicated that were several students who ad-
justed their chairs at home while using a computer.
However, a majority of students tested did not adjust
the height of their chairs at home or at school. It can
be assumed that the students who normally adjust their
chairs at home would also adjust their chairs in the
classroom, if the proper seating accommodations were
implemented.
Furthermore, results revealed that the less time a stu-
dent spends utilizing a computer per day, the less likely
he or she is to adjust the height of his or her chair.
Therefore, students who use a computer for short peri-
ods of time may find it tedious to adjust the workstation
to fit his or her body. As a result, many students assume
awkward postures to fit into a computer workstation
that is not adjusted appropriately.
According to the results a majority of students uti-
lized a computer for 1–2 hours daily. Many students,
however, stated they used the Internet for approxi-
mately 3–4 hours daily. Therefore, it is possible that
 J. Shinn et al. / The effectiveness of ergonomic intervention in the classroom
students surveyed did not accurately report the amount
of time they spent on a computer daily.
Additionally, results indicated that most students en-
gage in activities such as listening to music and watch-
ing television while on the computer. Therefore, other
mediums distract a majority of students that utilize a
computer daily. These distractions may result in re-
duced attention to form and posture, while increasing
the risk for musculoskeletal strain and injury.
4.2. Recommendations
In order to reduce the musculoskeletal strain that
can result from utilizing computer workstations some
ergonomic changes should be implemented. For ex-
ample, upgrading all computers to include adjustable
VDT’s can greatly reduce strain to the head, neck and
shoulders. An alternative to this recommendation is
to raise each of the VDT’s with devices such as books
or other sturdy materials to ensure that every student,
while seated, is at eye level with the VDT. Chairs should
be replaced with adjustable, five star caster chairs and
foot rests. Adjustable chairs can provide the correct
support for students who remain seated in hard, fixed
angled chairs. Non-adjustable computer tables can
be replaced with adjustable computer desks that are
equipped with keyboard trays. However, on a limited
budget, purchasing adjustable computer desks may not
be necessary if adjustable chairs, use of footrests and
proper ergonomic education are implemented.
In order to reduce glare, workstations should be re-
arranged so that they are positioned perpendicular to
the windows. When computer workstations are placed
parallel to the windows, glare is created on the VDT.
This glare is created from windows that are positioned
either behind or facing the user and can increase eye-
strain. Additionally, in order to reduce glare from over-
head fluorescent lighting, individual task lights for each
computer can be purchased.
Recommendations also include implementing er-
gonomics as an integral part of the word processing
curriculum. An occupational therapist through evalua-
tion of environment and education can provide teachers
with the tools they need to reinforce proper ergonomics
for computer use on a daily basis.
4.3. Summary
Computers have become an integral part of school
curriculums and many schools have designated com-
puter classrooms. However, computer classrooms do
71
more than promote reliable computer skills when they
lack adjustable chairs, tables, VDT’s, foot rests and
proper lighting. They promote awkward positioning
and poor posture that can become habitual and place
students at risk for developing CTD’s in the future.
The risk for developing CTD’s increases with ev-
ery hour spent awkwardly positioned at a computer
workstation [3]. Students within the New York Middle
School utilize a computer for a minimum of 45 minutes
per day within classrooms that cannot accommodate for
varying heights of individuals. Additionally, a majority
of the sixth grade students who utilize these computer
classrooms, do not possess enough ergonomic knowl-
edge to protect themselves from injury, while utilizing
a computer at home and in school.
The results of this study suggest that ergonomic
knowledge can increase through education. The current
curriculum within the word processing classes at the
New York Middle School teach students how to sit up
straight, while placing feet flat on the floor. However,
through observation it was apparent that in the absence
of adjustable chairs, several students cannot reach the
floor and others slouch to see the VDT. It is important to
note that ergonomic education must be supplemented
with the opportunity to practice proper ergonomics. A
weakness that was apparent in this study was students
who participated were not re-tested after an extended
period of time to measure retention of knowledge. Im-
mediate re-testing following the in-service proved there
was a statistically significant increase in scores on pre
and post-tests and therefore infers learning took place.
However, re-testing four to six weeks’ post in-service
would provide greater information regarding the reten-
tion of knowledge that took place in this study. Addi-
tionally, to strengthen the results of this study, students
should be supplied with the correct environment and
tools necessary to practice what they learned during the
in-service. Carry over of ergonomic knowledge can
be diminished when a classroom environment does not
provide students with the tools and equipment neces-
sary to practice healthy ergonomics.
Although there has been no statistical data on
CTD’s and children its effects on adults are known.
This should be evidence enough to begin preventative
education early. It should be of primary importance
for school administration to not only incorporate er-
gonomic education as part of a computer curriculum,
but to ensure that every computer classroom provides
a proper environmental fit for all students. The health
benefits for children should out-weigh any costs associ-
ated with modifying classroom environments. School
72 J. Shinn et al. / The effectiveness of ergonomic intervention in the classroom

districts need to consider the cost of long-term damage a.) YES b.) NO
that may occur if they neglect to make basic changes in
If yes . . .
computer classrooms. Classroom environments should
5.) Approximately how many times do you break
facilitate not impede a student’s chance to practice
during 1 hour at the computer?
healthy ergonomics.
a.) Once b.) Twice
c.) Three or more
Acknowledments
6.) How long do you break? Minutes
7.) Do you watch television, listen to music, do
We would like to acknowledge Karen Jacobs, Pres-
homework while on the computer?
ident of the American Occupational Therapy Associa-
tion for her time and guidance during this project. We a.) YES b.) NO
would also like to acknowledge Tara Casimano and
8.) Do you ever adjust the height of your computer
Joseph Indelicato for their support and direction. Fi-
chair . . .?
nally, we would like to officially thank our families for
their endless support of our ideas and efforts. a.) In school b.) At home
c.) Both d.) Neither

References
CIRCLE THE CORRECT ANSWER
[1] T. Albin and S. Gutman, Minor adjustments; Unshackle office
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users, Computers in Libraries 16(8) (1996), 40–45.
[3] M.C. Hickey, Mom, my back really hurts, Business Week (Au- a.) tilt the monitor up
gust 16, 1999), 115. b.) tilt the monitor down
[4] M. Miller, Ergonomic seating: the key to achieving comfort c.) make sure the monitor is at eye level
and productivity, Advance/Rehabilitation 4(7) (1995), 91–95.
[5] L.W. Pedretti, Practice skills for physical dysfunction, Mosby- 2. Sitting at the edge of your chair . . .
Year Book, Inc., St. Louis, Missouri, 1996.
[6] B.M. Seymour, The ergonomics of seating posture and chair a.) helps maintain good posture
adjustment, Nursing Times 91(9) (1995), 35–37. b.) puts stress on your lower back
[7] R.S. Stock, Workplace Ergonomic Factors and The Devel-
opment of Musculoskeletal Disorders of the Neck and Up- c.) affects your vision
per Limbs: A Meta-Analyis, American Journal of Industrial d.) none of the above
Medicine 19 (1991), 87–107.
[8] B. Yeats, Factors that may influence the postural health of 3. Should your back make contact with the chair back?
schoolchildren (K-12), Work 9(1) (1997), 45–55.
a.) YES or b.) NO
4. Which is the best position of your feet/legs while
Appendix 1 sitting at the computer?
a.) they should be dangling, not able to reach the
Occupational Therapy Survey
floor
b.) your legs should be crossed
Please answer all questions honestly and to the best of
c.) both should be placed on foot rest if not able to
your ability. Thanks for your help!
reach the floor
1.) How old are you? d.) scoot forward on your chair so that your feet can
2.) What is your gender? Male or Female touch the floor
3.) How many hours do you use a computer per day
5. To reduce glare on the computer screen . . .
during school and at home?
a.) adjust blinds and curtains
a.) 1–2 hours b.) 3-4 hours
b.) use lower wattage bulbs to light room
c.) 5-6 hours d.) More than 6 hours
c.) use a glare guard on computer screen
4.) Do you take breaks when you use a computer? d.) all of the above
 J. Shinn et al. / The effectiveness of ergonomic intervention in the classroom 73

6. It is OK to place the keyboard on your lap if that is CHAIR

most comfortable for you.
– Adjustable back rest
a.) TRUE b.) FALSE – Adjustable seat height
– Available foot rest
7. When using a computer your wrists should be:
– Seat angle 5-10 degrees
a.) supported and straight – Appropriate lower back support
b.) which ever position is most comfortable for you – Seats firm and upholstered
c.) bent towards the keyboard – Chair mobility (wheels, swivel)
d.) none of the above – Five star casters
– Ample leg room
8. Pushing down hard on the computer keys while
typing may result in injury to the joints of your hand? VDT
a.) TRUE b.) FALSE – VDT adjustable in all angles
– Document holder . . . location of holder
9. It is better to . . .
– Adjustable screen contrast and brightness
a.) do computer work without breaks – Screen clean to reduce eye strain
b.) interrupt work with frequent breaks
KEYBOARD
c.) type one sentence every hour
d.) none of the above – Wrist rests
– Detachable and moveable
10. Using a mouse without taking breaks is good for
– Adjustable keyboard tray
your body.
MOUSE
a.) TRUE b.) FALSE
– Adjustable keyboard tray with room for mouse
11. Can children suffer from joint and muscle injuries
– Positioned close to keyboard
from using a computer?
– Same height as keyboard
a.) YES b.) NO
LIGHTING
– Adjustable window coverings
Appendix 2 – Minimal reflective surfaces in work area (white
paper, reflective items)
ERGONOMIC CHECKLIST – Task lights available
– Monitors not parallel to windows
TABLE TOP
– Adjustable table