Many people will probably respond to this with all kinds of chair recomendations, but I just want to say first off that you should not be sitting in ANY chair from morning until you go to sleep. Our bodies need to move, change positions and change activities throughout the day. So at the very least, take short breaks from sitting every hour-for at least 5-10 minutes. There are many stretching programs you can do at your desk, and give your eyes a break too. This alone should help prevent any problems, however a good chair is a necessity for you since you are sitting for so long. Make sure you have full back support and many adjustments so that you can change positioning depending on your tasks and how your body is feeling that day. OK, folks, have at it with the chair recs, but I just had to get this in!! Take care of your body. It's the only one you have!!
Kathleen Shanfield, OTR/L, MS,ATP
No I did not. Apparently it is not sold in the US anymore, and our customer could not deal with anyone outside of the US. I found a chair vendor who had sold many of the chairs to a large lab and he still called on those customers and said he would keep an eye out for discarded ones and try and get the part we needed (one side of the split back). But so far no luck.
Too bad. That chair did help a lot of folks, but I guess there just wasn't a big enough market.
There are a few L click adapters in the assistive technology market to replace the L click with a switch. The website http://www.ablenetinc.com and http://www.infogrip.com carry the following products to enable one to separate the L click from the mouse itself and use a switch.
Swifty is a USB adapter that allows any switch to be plugged into it and used as the L click. (Infogrip)
There is a switch adapted mouse (they did exactly what you did ), that will allow you to plug in a switch for either a L or R click. (Infogrip)
Another device called Switch Click is a combined switch and adapter (from Ablenet)
The wireless Switch Interface and the Switch Interface Pro allow one to use a switch for a variety of "clicks" and functions.
All of these devices are under $100.00.
Both of these companies also sell the switches of which there are many. The most common one I recomend is the Microlight switch and it can easily be held between the thumb and index finger or velcroed down to the table and just hit with the side of the hand or the thumb.
Sorry you did not find these devices while you were searching. The world of Assistive Technology has a lot to offer, but is not on the same pages as the mainstream devices so often do not show up in searches. Anyway, hope this opens up a whole new world for you to consider when searching for devices.
Kathleen Shanfield, OTR, MS, ATP
You do not mention why the person is in the wheelchair, i.e. diagnosis, however I would not change the way the person is sitting since there is probably is a good reason they are positioned in their chair this way. If they have very little trunk/pelvic control, this position will keep them from sliding out of their chair. If they have neurological issues like spasticity, this position may inhibit some of that spasticity. Many of the sports wheelchairs use this positioning as it makes it easier and more efficient to reach the wheels and maneuver the chair. However you bring up a good point about proper seating for wheelchair users at a desk, since it is very different than non-wheelchair user. I find in my practice that I build the workstation around the person seated in the wheelchair (hopefully comfortably and effectively) by looking at desk height, arm support, and monitor placement. Keyboard placement can best be achieved usually by an adjustable keyboard drawer rather than trying to type on the desktop.
If your client is not comfortable sitting this way, then he needs to be evaluated by a wheelchair seating specialist, usually a PT or OT, and have changes made to the chair and cushion if need be.
Kathleen Shanfield, OTR/L, MS,ATP
I have used a Universal Switch mount with a large mounting plate for keyboards at a variety of sites. The clamp can attach just about anywhere, and you can lock it at any angle you want. It’s worth a try to see if this provides the flexibility and postitioning you want. You can find the universal switch mount at infogrip.com or ablenetinc.com. Be sure and get the large mounting plate. Depending on the size of the keyboard, you may need to modify the plate so that it provides a stable platform.
Just a word of caution. Many of my patients who have been feet typists have experienced overuse and pain syndromes over the years. One patient overused so much with typing that she could not walk for weeks. Since they use their feet for everything, it is important to prioritize and there are so many more altenatives to typing-voice recognition, mouth and chin controllers with onscreen keyboards, etc. Positioning, taking frequent breaks, stretching, etc. will be very important for this employee as it is for all. Good luck.
Kathleen Shanfield, OTR/L, MS, ATP
I have set up folks doing Medical Transcribing (and sewing) with the foot plate contoller at the knee. Using a Universal Switch Mount (infogrip.com), or any other adjustable mounting device mounted to the chair, you can velcro the pedal onto a switch plate and place it outside or inside the knee. It is easier for some folks to move the knee laterally, than to lift the foot up against gravity to come off the footplate. To avoid fatiguing any one set of muscles or limb, the universal switch mount can be moved around to the other leg/knee after a period of time. Just an idea worth trying. Hope it helps.
Kathleen Shanfield, OTR/L,MS,CVE
As an Occupational Therapist doing ergonomics for well employees, as well as working with patients being rehabilitated from stroke, amputations, etc. I have found many different one handed typing methods that work. The most basic (and cheapest) is to teach a one handed typing method on a traditional keyboard. There are programs available that one can download as well as manuals that will teach the one handed method of typing, which basically reassigns the keys to individual fingers. Check out Accessibility features such as Sticky Keys in the Accessibility icon in Windows to allow sequential keystroking vs. simultaneous-very helpful for one handed typing.
Other suggestions are to use a smaller keyboard so that the hand does not have to stretch as far to reach keys. Using the mouse or a trackball with the Windows onscreen keyboard (Start>All Programs>Accessories> Accessibility>Onscreen Keyboard) or downloadable onscreen keyboards with features like word prediction for rate enhancement, can also be easier for some folks who may want a break from the traditional keyboard. I have tried some of the one handed keyboards with my patients and have found that they are not any faster than learning a one handed method, and it does increase the cognitive load.
A very successful one handed method is the BAT keyboard by Infogrip. (Infogrip.com). This is a “chorded” keyboard, that was designed to be used by one handed typists. It does require learning a different method of typing, however it is not difficult. Apparently many architects and drafting specialties use it, as it frees up the other hand to use the mouse while drawing, etc.
For my serious one handed employees that need to do a lot of text input quickly, this is the one I try the most. It is also great for those with visual impairments as the hand does not have to leave the BAT keyboard while typing.
Finally, there is voice recognition, which is becoming probably the most common alternative to using the keyboard as it is affordable and has increased accuracy and speed over all other methods once the user has mastered using it. The actual skill of dictating hangs up many people, so it is always good to have an alternative or backup to this method.
As with any repetitive activity it is especially important to take frequent breaks and to rest/stretch the typing hand. If this is the person’s only usable hand, it is especially important to protect and conserve, support and minimize injury to that hand that will be “overused” and stressed if the person is not careful. Seen that a lot!
Hope this helps.
Kathleen Shanfield, OTR/L, MS
These items are for a totally different population group, but they do work for monitoring posture. Try looking at http://www.enablingdevices.com at the tilt switch, and the Musical posture trainer.
Both of these devices are intended for people with disabilities where they require reminders to keep the head up or keep good posture, which is basically what we all want our workers to do also.
Hope this helps.
Kathleen Shanfield, OTR/L, MS, CVE
sorry this has taken awhile to get online. I accidentally posted it in the wrong section! Better late than never!
To add to the great recomendations already, I would like to suggest a commercially available switch adapted mouse (from Infogrip for about $50.00) and a switch (range from $50.00 up, also on Infogrip). Commonly used switches are the Jellybean or Buddy switches, or for very light touch ther is the microlite. Switches can be mounted anywhere (with good old velcro), and used with any part of the body. The switch adapted mouse has a port for both the left and right click, but most of the time I find folks can get by with just adapting the left click. The switch adapted mouse is a regular mouse, and the switch can be used by the opposite hand, or any other access site for the "click". I also often recomend "Dragger" or other dwell programs to eliminate the need to click to select. Voice recognition is great for text input, but a little bulky and slow for mouse movements and making selections. Good luck and have fun with this. They are easy solutions that can solve lots of problems. Kathleen Shanfield, OTR/L
I assumed that information would easily be found in the Federal Register for the Americans with Disability Act (ADA) however not the case, but I did not spend a lot of time there. I just wanted to pass that resource on as a possibility. It may be hidden deeper than I looked. Try http://www.ada.gov/, and http://www.access-board.gov/adaag/about/index.htm. They had to base these measurements and guidelines on "generic" wheelchair users with certain anthropometric stats. Hope this helps.
Kathleen Shanfield, OTR/L,MS
Some people with Rheumatoid arthritis (RA) find they are more comfortable with less hip flexion, more hip extension, for example the backrest could be reclined a bit more for her. This may not be ideal for typing since it will put her farther away from her keyboard, but it’s worth a try to readjust everything to be closer. She may also find it more comfortable for her seat to be adjusted a little bit higher to allow less hip flexion. I have worked with some folks with RA who are most comfortable in a very high seat like a bar stool, or drafting stool, where they are half sitting/standing. This then requires a higher desk or work surface and other modifications to bring items close and accessible. Ideally, she should be changing her position frequently (every 30 minutes), take frequent breaks, watch the temperature (cold temps can exacerbate the pain from arthritis) and be followed regularly by her doctor. Many with RA have trouble being comfortable with any position so the goal should be to find some combination of postures that she can tolerate and rotate through them during the day.
I also find that it is nice to give folks options. I do recomend if they are going to rest their arms on the desktop to support their forearms while typing, that they adjust their chairs a little higher than if they were to use a keyboard drawer. This keeps them from or hiking or flexing the shoulders to reach the keyboard. Sometimes this adjustment requires the user to use a footrest. I also LOVE the Ergorest arm supports and find they solve many problems for both prevention and supporting an injured arm.
I recomend Dragon Naturally Speaking for a variety of reasons, and it sounds like you should give it a try. Depending on your workstation, it may be the best solution for your longer text typing needs. I say depending on your workstation because usually I recomend it be used in a fairly quiet environment, and one where your dictating will not bother other workers. You may find that you can use it for just long text and to open/close programs in command mode, and then use the mouse and keyboard for everything else. You can operate the mouse by voice however it is a little tedious and usually folks with some hand function will opt to continue to use the mouse. There are definitely skills involved in dictating that some people just can’t seem to master, however with practice most folks can learn. The newest version of Dragon is 10, and you can get it online at http://www.nuance.com. The Standard Version is $99.00 and definitely worth every cent as far as I’m concerned. I just bought it for myself, loaded it up, put on the headphone microphone, did not do any training, and started dictating and it was 100% accurate.
The other most important thing is the mini breaks-stretching and alternating tasks every 30 minutes. I like the software that reminds me –www.stretchware.com. Check it out and good luck.
A trackball, especially those with the bigger balls like a Kensington Expert Mouse, would allow one to not have to use the thumb at all. It also may be helpful to switch the buttons on the trackball, so that the left click is on the right. To do this in Windows, just go to Control Panel, then to Mouse, then to Button Configuration.
The Kensington Expert Mouse has 4 buttons that can be configured however you want. Good luck!
You may also consider voice recognition software. I work with many patients with MS and other neurological disorders that cause weakness and incoordination, and they find the voice recognition products to truly be the easiest and most efficient methods for long stretches of data entry or text input. Dragon Naturally Speaking has a new version (10), and it is compatible with most data entry programs. It is worth a try. The software and microphone headset are available at most computer stores or at nuance.com.
Arm supports such as ergo arms and general posture and positioning can also be very helpful.