Reduced inclination of cervical spine in a novel notebook screen system - implications for rehabilitation
© Quarcoo et al; licensee BioMed Central Ltd. 2011
Received: 28 May 2010
Accepted: 25 November 2011
Published: 25 November 2011
Professional working at computer notebooks is associated with high requirements on the body posture in the seated position. By the high continuous static muscle stress resulting from this position at notebooks, professionals frequently working at notebooks for long hours are exposed to an increased risk of musculoskeletal complaints. Especially in subjects with back pain, new notebooks should be evaluated with a focus on rehabilitative issues.
In a field study a new notebook design with adjustable screen was analyzed and compared to standard notebook position.
There are highly significant differences in the visual axis of individuals who are seated in the novel notebook position in comparison to the standard position. Also, differences are present between further alternative notebook positions. Testing of gender and glasses did not reveal influences.
This study demonstrates that notebooks with adjustable screen may be used to improve the posture. Future studies may focus on patients with musculoskeletal diseases.
The increasing mobility together with growing work intensification results in the desire to use traveling time to continue computer based work. Therefore the amount of mobile computer units such as notebooks etc. has increased over time . Owing to the compact design these units do not comply with above mentioned guide lines. Docking station and extern keypads might alleviate some concerns but the problem of an unfavorable visual axis remains.
Owing to the difficult ergonomic situation notebooks might easily become a hindrance for productivity and a potential problem for the well being and health .
Recently this problem was addressed by the novel design of the notebook lid that allows the extension of the screen in a vertical plane. The concept envisions that in operation modus the screen is lifted various steps upwards and locked in place to allow a more extended position of the cervical spine.
The aim of the current study was to analyze characteristics of a note book with a variable extended screen system. We hypothesize that the new system leads to a lower degree of inclination and may therefore serve for rehabilitative issues
Materials and methods
Anthropomorphic data of test persons
Determination of cervical flexion
Different experimental positions
Straight visual axis, without gazing to the computer screen.
Maximal extension of computer screen (38 cm upper edge of screen)
Second extension of computer screen (33 cm upper edge of screen)
Second extension of computer screen (31 cm upper edge of screen)
Common notebook screen position (27 cm upper edge of screen)
The local ethics committee approved the study and the participants gave their informed written consent prior to inclusion in the study.
Results are expressed as means with standard deviations (SD). Due to the small sample size non-parametric methods were used, because they are more robust. Φ was used instead of the chi-square distribution if the frequencies were too low (more than 20% of the cells had an expected count less than 5) to avoid type II errors. A p-value of less than .05 was considered significant. Analyses were performed using SPSS version 17.0.
The inclination was determined using optical measurements. To verify the results a photo digital overlay technique was used that demonstrated substantial differences in the various positions (Figure 3).
Cervical inclination in different positions
Differences between the experimental positions
φ = 1.7*
φ = 1,6
φ = 2.2
φ = 1,9
φ = 2.5
φ = 2.8**
φ = 1.8
φ = 2.6**
φ = 2.7**
φ = 2.9*
Gender influence on cervical inclination
Influence of corrective lenses on cervical inclination
The increasing mobile use of notebooks poses a problematic ergonomic situation. To circumvent some of the negative effects on the musculoskeletal system that occurs with the unfavorable body position a novel screen system was designed. This height adjustable display was evaluated in the current study. The cervical inclination that corresponded to the five position of the computer display differed significant in all subjects resulting in a reduced flexion in the maximum moved out position.
The vertical strain on the spine is reflected by the force that acts on the intravertebral discs that lead to changes in the intradiscal pressure (PID). It has been suggested that an increased PID may worsen the alimentary status of the intravertebral disc that might contribute to a faster advancing of degenerative processes [8–10]. Studying the lumbar spinal region Nachemson and coworker demonstrated that different body postures influence the intradiscal pressure [11, 12]. The results were confirmed by data from discography and chemonucleolysis . There are important differences between the sections of the spine. In cervical discs, the nucleus is less able to equalize stress over large distances, and the posterior annulus does not sustain high compressive stresses . Although most research focused on the lumbar spine, recent data has found a postural dependence also for the cervical spine [8, 9]. PID is lowest in the middle position between flexion and extension . This relation has found expression in national guidelines where an only marginal flexion of the neck with the least stress is favored for the working environment.
Next we evaluated factors that might influence the extent of inclination. In this context Nightingale and coworker have found gender specific anatomic differences of the cervical spine. The male upper cervical spine is significantly stiffer and stronger . In our study population there was no difference between the neck inclination of the male and female subjects.
Also for another possible influencing factor - the wearing of correction lenses - no distinction was found, supporting the relevance of the data.
In summary the moved out position of a new height adjustable notebook display reduces significantly the cervical inclination. From data that the vertical strain on the cervical spine depends on the degree of inclination, it may be assumed that in this position the strain is reduced. The novel screen advances the notebook display ergonomically next to desktops. It may be especially beneficial in rehabilitation.
Future studies will evaluate the novel displays' ability to reverse already set in damages of the musculoskeletal system. Furthermore the influence on the upper body and the position of the keyboard will be future research topics.
Conflict of interests
This study was funded by Dreamcom Deutschland GmbH. The views in this article are the personal views of the authors and do not necessarily represent the views of the professional organizations or institutions within which we are members.
The authors would like to thank I. Kölzow for excellent technical support and all individuals who participated in the study as subjects.
- Rürup BS: Werner Wirtschafts- und Arbeitswelt. In Deutschland Trendbuch Fakten und Orientierungen. Edited by: Korte K-RW. Werner: Leske+Budrich, Opladen; 2001:251.Google Scholar
- EU-OSHA: Expert forecast on emerging physical risks related to occupational safety and health. Luxembourg: Office for Official Publications of the European Communities; 2005.Google Scholar
- Cote P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, Carragee EJ, Haldeman S, Nordin M, Hurwitz EL, et al.: The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Journal of manipulative and physiological therapeutics 2009, 32: S70–86. 10.1016/j.jmpt.2008.11.012View ArticlePubMedGoogle Scholar
- Working conditions in Germany - Strains, requirements and health[http://www.baua.de/cln_103/en/Topics-from-A-to-Z/Working-Conditions/Working-Conditions.html]
- Bildschirmarbeitsverordnung Verordnung über Sicherheit und Gesundheitsschutz bei der Arbeit an Bildschirmgeräten[http://www.gesetze-im-internet.de/bundesrecht/bildscharbv/gesamt.pdf]
- Display s: Quarterly Notebook PC Shipment and Forecast Report 2009.Google Scholar
- Brooks PM: The burden of musculoskeletal disease--a global perspective. Clinical rheumatology 2006, 25: 778–781. 10.1007/s10067-006-0240-3View ArticlePubMedGoogle Scholar
- Kambin P, Abda S, Kurpicki F: Intradiskal pressure and volume recording: evaluation of normal and abnormal cervical disks. Clinical orthopaedics and related research 1980, 144–147.Google Scholar
- Pospiech J, Stolke D, Wilke HJ, Claes LE: Intradiscal pressure recordings in the cervical spine. Neurosurgery 1999, 44: 379–384. discussion 384–375 10.1097/00006123-199902000-00078View ArticlePubMedGoogle Scholar
- Ranu HS: Time dependent response of human intervertebral disc to loading. Engineering in medicine 1985, 14: 43–45. 10.1243/EMED_JOUR_1985_014_008_02View ArticlePubMedGoogle Scholar
- Nachemson A: The load on lumbar disks in different positions of the body. Clinical orthopaedics and related research 1966, 45: 107–122.View ArticlePubMedGoogle Scholar
- Nachemson A, Morris J: Lumbar discometry. Lumbar intradiscal pressure measurements in vivo. Lancet 1963, 1: 1140–1142.View ArticlePubMedGoogle Scholar
- Skrzypiec DM, Pollintine P, Przybyla A, Dolan P, Adams MA: The internal mechanical properties of cervical intervertebral discs as revealed by stress profilometry. Eur Spine J 2007, 16: 1701–1709. 10.1007/s00586-007-0458-zPubMed CentralView ArticlePubMedGoogle Scholar
- Nightingale RW, Carol Chancey V, Ottaviano D, Luck JF, Tran L, Prange M, Myers BS: Flexion and extension structural properties and strengths for male cervical spine segments. Journal of biomechanics 2007, 40: 535–542. 10.1016/j.jbiomech.2006.02.015View ArticlePubMedGoogle Scholar
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