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Work. 2013;44(2):221-30. doi: 10.3233/WOR-121584.

An ergonomics training program for student notebook computer users: preliminary outcomes of a six-year cohort study.

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Boston University, College of Health and Rehabilitation Sciences, Sargent College, Department of Occupational Therapy, Boston, MA 02215, USA.



The Maine Learning Technology Initiative (MLTI) is a program established in the state of Maine in the United States of America, where all students in 7th and 8th grades are provided with a notebook computer to use at school and at home during the academic year.


This study aimed to describe the anthropometric measurements and typing proficiency of a cohort of students in the MLTI. It also investigated the impact of participatory ergonomics education and use of peripheral notebook accessories on their reported musculoskeletal and visual discomfort over the first three years of a six year study.


This longitudinal study commenced in 2009 with 34 students in 7th grade consenting to participate for six years through the 12th grade. Students received ergonomics education about healthy notebook use, reinforced with web-based resources; and were provided with peripheral notebook accessories including a notebook riser, and external keyboard (split or non-split) and mouse.


The use of an external keyboard resulted in a reduction in neck and shoulder pain. Participants self-reported fewer headaches when using an external mouse. Using no external accessories was associated with self-reported back pain. Although other musculoskeletal discomforts decreased over time, the changes were not statistically significant. There was a trend for the reduction of visual symptoms including dry/watery eyes and sore, tired eyes during the study.


Participatory ergonomics training and use of external devices may have significant health benefits for children involved in notebook programs who have daily exposure to this technology for school and leisure purposes. Internal and external validity of the results were limited by small sample size.

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