TIP 1 Projects

TIP-1: Workplace ergonomics assessments and recommendations of computer workstations for workers with rheumatoid arthritis


Nancy A. Baker, ScD, OTR/L
Assistant Professor, University of Pittsburgh, Department of Occupational Therapy, Pittsburgh, PA;

Karen Jacobs, EdD, CPE, OTR/L, FAOTA
Clinical Professor, Program Director, Post-professional Distance Education Occupational Therapy Programs Boston University


Arthritis is the 3rd leading cause of work disability in the United States [1], and can lead to serious financial, social, and psychosocial consequences. Unfortunately, interventions to reduce work disability are rarely undertaken during the management of arthritis [2-5]. Although many factors contribute to work disability in people with arthritis, the physical demands of a job are a consistent predictor [6, 7]. To cope with these demands, workers with arthritis often shift to jobs that are perceived as less physically demanding, but require computer use—a problematic activity for people with arthritis [8]. Although computer use problems can be addressed through environmental modification, computer users with arthritis may not be aware of these options [9]. Ergonomic assessments by occupational therapists (OTs) and physical therapists (PTs) (rehabilitation therapists, RTs) can provide recommendations for implementing workstation modifications that reduce computer use problems and, thereby, work disability. With their knowledge of both the effects of impairment on performance and their ability to evaluate the workplace and identify adaptive strategies for alleviating work disability, RTs are the ideal professionals to provide these assessments. Unfortunately, computer users with arthritis often do not have access to RTs who can provide ergonomic assessments.

One innovative method to surmount this problem and provide access to RT assessments is telerehabilitation. Telerehabilitation uses web-based technologies, such as web cameras, to provide remote delivery of rehabilitation. This project will be the first to develop a valid and reliable remote systematic ergonomics program aimed at substantially reducing work disability among workers with any type of arthritis. In this project we propose to develop the Telerehabilitation Computer Ergonomics System (tele-CES) for computer users with arthritis. The tele-CES will use existing validated ergonomic assessments and will provide RTs with a valid and reliable method to: 1) remotely assess the computer workstation environment; and 2) generate explicit participant-specific workstation modification recommendations based on these assessments. The recommendations will be easily implemented, will reduce pain, discomfort, and fatigue, and will eliminate or reduce barriers to work productivity.

Project Objective(s):

The aims of the proposed project are to:


This project will have three Phases. In Phase I, we will develop the tele-CES program and create the tele-CES web portal. In Phase II we will establish concurrent-criterion validity by comparing recommendations for modification of the computer workstations of 50 computer users with arthritis made by two expert RTs, one using tele-CES and the other using onsite assessment methods, onsite-CES. We will establish inter-rater reliability by comparing the recommendations for the same 50 computer users made by two RTs, each independently using the tele-CES. In Phase III, we will provide the computer users with the recommendations obtained using the tele-CES. We will follow-up three months later to determine the participants’ success in implementing the recommendations, and the effectiveness of the recommendations in reducing pain, discomfort, fatigue, and on increasing productivity.

Expected Findings and Deliverables:

The deliverable will be a TR system to deliver ergonomics assessments and recommendations for computer users with rheumatoid arthritis – the tele-CES

Project Updates (most recent listed first):

Field Initiated Project submitted to National Institute on Disability and Rehabilitation Research (NIDRR), December, 2009.


1. Theis, K.A., et al., Prevalence and correlates of arthritis-attributable work limitation in the US population among persons ages 18-64: 2002 National Health Interview Survey Data. Arthritis & Rheumatism, 2007. 57(3): p. 355-63.
2. Backman, C., J. Village, and D. Lacaille, The Ergonomic Assessment Tool for Arthritis: Development and pilot testing. Arthritis & Rheumatism (Arthritis Care & Research), 2008. 59(10): p. 1495-1503.
3. Lacaille, D., et al., Identification of modifiable work-related factors that influence the risk of work disability in rheumatoid arthritis. Arthritis & Rheumatism, 2004. 51(5): p. 843-52.
4. Lacaille, D., et al., Problems faced at work due to inflammatory arthritis: New insights gained from understanding patients' perspective. Arthritis Care & Research, 2007. 57(7): p. 1269-1279.
5. Mancuso, C.A., S.A. Paget, and M.E. Charlson, Adaptations made by rheumatoid arthritis patients to continue working: a pilot study of work place challenges and successful adaptations. Arthritis Care & Research, 2000. 13(2): p. 89-99.
6. Allaire, S.H., Update on work disability in rheumatic diseases. Current Opinion in Rheumatology, 2001. 13(2): p. 93-8.
7. Allaire, S.H., W. Li, and M. LaValley, Work barriers experienced and job accommodations used by person with arthritis and other rheumatic diseases. Rehabilitation Counseling Bulletin, 2003. 46: p. 147-156.
8. Baker, N.A., et al., Problems experienced by people with arthritis when using a computer Arthritis & Rheumatism (Arthritis Care & Research), 2009. 61: p. 614-622.
9. Baker, N.A. and J.C. Rogers, Problems and coping strategies reported by computer users with RA. Arthritis & Rheumatism, 2009. 60((10 supp)): p. S694.


Project Update


Activity on this project has been suspended pending external funding.


Back to D3 Technology Implementation Projects (TIPs)




Journal of Telerehabilitation


D3 video screen on YouTube

TeleWellness: Interactive Mobile Health and Rehabilitation



Facebook   Twitter   LinkedIn  

You Tube