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Evaluation of flat, angled, and vertical computer mice and their effects on wrist posture, pointing performance, and preference


Abstract and Figures

Background: Modern computer users use the mouse almost three times as much as the keyboard. As exposure rates are high, improving upper extremity posture while using a computer mouse is desirable due to the fact that posture is one risk factor for injury. Previous studies have found posture benefits associated with using alternative mouse designs, but at the cost of performance and preference. Objective: To develop new computer mouse shapes, evaluate them versus benchmarks, and determine whether there are differences in wrist posture, pointing performance, and subjective measures. Method: Three concept mice were designed and evaluated relative to two existing benchmark models: a traditional flat mouse, and an alternative upright mouse. Using a repeated measures design, twelve subjects performed a standardized point-and-click task with each mouse. Pointing performance and wrist posture was measured, along with perceived fatigue ratings and subjective preferences pre and post use. Results: All of the concept mice were shown to reduce forearm pronation relative to the traditional flat mouse. There were no differences in pointing performance between the traditional flat mouse and the concept mice. In contrast, the fully vertical mouse reduced pronation but had the poorest pointing performance. Perceived fatigue and subjective preferences were consistently better for one concept mouse. Conclusion: Increasing mouse height and angling the mouse topcase can improve wrist posture without negatively affecting performance.
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Work 52 (2015) 245–253
IOS Press
Evaluation of flat, angled, and vertical
computer mice and their effects on wrist
posture, pointing performance, and preference
Dan Odella,and Peter Johnsonb
aSynaptics, Inc., San Jose, CA, USA
bSchool of Public Health, University of Washington, Seattle, WA, USA
Received 3 March 2014
Accepted 7 May 2014
BACKGROUND: Modern computer users use the mouse almost three times as much as the keyboard. As exposure rates are high,
improving upper extremity posture while using a computer mouse is desirable due to the fact that posture is one risk factor for
injury. Previous studies have found posture benefits associated with using alternative mouse designs, but at the cost of performance
and preference.
OBJECTIVE: To develop new computer mouse shapes, evaluate them versus benchmarks, and determine whether there are
differences in wrist posture, pointing performance, and subjective measures.
METHOD: Three concept mice were designed and evaluated relative to two existing benchmark models: a traditional flat mouse,
and an alternative upright mouse. Using a repeated measures design, twelve subjects performed a standardized point-and-click
task with each mouse. Pointing performance and wrist posture was measured, along with perceived fatigue ratings and subjective
preferences pre and post use.
RESULTS: All of the concept mice were shown to reduce forearm pronation relative to the traditional flat mouse. There were no
differences in pointing performance between the traditional flat mouse and the concept mice. In contrast, the fully vertical mouse
reduced pronation but had the poorest pointing performance. Perceived fatigue and subjective preferences were consistently better
for one concept mouse.
CONCLUSION: Increasing mouse height and angling the mouse topcase can improve wrist posture without negatively affecting
Keywords: Human-computer interaction, design, ergonomics
1. Introduction
The trend in computer input has shifted away from
keyboard input to pointing device input as user inter-
faces have evolved from text-based to graphical user
Address for correspondence: Dan Odell, Synaptics, Inc., San
Jose, CA, USA. E-mail:
interfaces. Today, average active time on the mouse
exceeds average active time on the keyboard by almost
3 to 1 [4, 12, 22]. The number of hours per day working
on a computer has been identified as one of the key risk
factors for Musculoskeletal Symptoms (MSS) [18], and
research has linked intensive mouse use to MSS [6, 13].
High incidence of computer related MSS of the upper
extremity has been reported, for example in a college
1051-9815/15/$35.00 © 2015 – IOS Press and the authors. All rights reserved
246 D. Odell and P. Johnson / Evaluation of flat, angled, and vertical computer mice
student population [28]. The higher durational exposure
of the mouse relative to the keyboard, and the observed
link between mouse use and MSS [8] emphasizes that
mouse design should be a key focus when seeking to
improve comfort at the computer.
Several commercially available mice have been
designed with the intent of improving user posture
during mousing by making them more vertical. Early
efforts focused on providing sculpted, non-symmetrical
mice that were designed to improve comfort and wrist
posture [1, 10]. Some of these mice designs have been
shown to provide better posture during mousing [10,
11, 25]. Other studies have shown benefits in reduced
muscle load for more vertical mice [11, 25, 27]. These
benefits can translate into longer term comfort benefits.
For example, testing of one vertical mouse demon-
strated that the upright pronation-reducing design was
successful at reducing subjective pain over a short
period of use [1]. Unfortunately, of the ‘neutral posture’
mice reported in the literature, all have shown reduced
pointing performance [1, 10, 25, 26]. Subjective pref-
erence measures have also generally been low for
these inclinced mice [1, 26]. Reduced pointing perfor-
mance and preference can serve as significant barriers
to widespread adoption of a pointing device despite
other ergonomic benefits that alternative designs may
In this study, three concept mice with angled topcases
were developed and evaluated against two benchmark
mice: a traditional flat mouse, and a commercially avail-
able vertical mouse. The intent behind the designs of the
concept mice was to reduce non-neutral upper extrem-
ity postures that may be associated with increased
risk for musculoskeletal discomfort, while maintaining
pointing performance. Specifically, the concept mice
were designed to reduce: 1) forearm pronation, 2) wrist
extension, 3) ulnar deviation, 4) extended finger pos-
tures, and 5) change the location of the contact area
between wrist and the desktop.
These design criteria were informed by existing
research on carpal tunnel pressure and wrist angle
[5, 15, 19, 21]. Hydrostatic fluid pressure within the
carpal tunnel has been one means to show the potential
risks associated with various forearm, wrist and fin-
ger postures. Non-neutral wrist and forearm postures
can increase the hydrostatic fluid pressure within the
carpal tunnel and the increased pressure can impair
nerve function and can lead to long-term damage [19,
21]. For example, Rempel et al. [19] determined that
45of forearm pronation and 45of finger flex-
ion were postures both associated with reduced carpal
tunnel pressure (CTP). These postures correspond with
the targeted forearm and finger postures outlined in the
mouse design criteria cited above. Similar to prona-
tion and finger extension, elevated fluid pressure in
the carpal tunnel has also been associated with wrist
extension and ulnar deviation [15]. This prompted the
design criteria to include promoting more neutral wrist
Elevated CTP is also associated with external con-
tact pressure on the palmar surfaces of the hand and
wrist. Cobb et al. [5] showed that certain areas of the
hand and wrist, especially the the base of the palm over
the flexor retinaculum, were sensitive to external con-
tact pressure. Contact pressure in those regions elevated
CTP. Therefore, another potential benefit of more ver-
tical concept mouse design may be to reduce contact
pressure in those sensitive areas by shifting the contact
area off of the base of the palm and to the ulnar aspect
of the hand.
After the three concept mice were developed, it was
important to evaluate them to determine how effective
they were in meeting the design criteria, and therefore if
any of them should be produced commercially. The goal
of this study was to make this evaluation of the concept
mice and determine whether there were benefits in wrist
posture, pointing performance, perceived fatigue and
preference relative to the flat and vertical benchmark
2. Methods
2.1. Subjects
Twelve experienced computer mouse users (6 male,
6 female) who all self-reported to use the computer
at least 10 hours a week were recruited to participate
in this study. The mean age of the subjects was 32.7
years (range 20–52) and all subjects used the mouse
with their right hand. Experimental procedures were
approved by the University of Washington Human Sub-
jects Committee and all subjects gave their informed
Using the methods outlined in the ADULTDATA
anthropometric handbook [30], hand length and hand
breadth were measured from all subjects. Hand length
was measured from the distal wrist crease to the tip
of the middle finger and and hand breadth was mea-
sured from the medial side of the palm just below the
little finger to the lateral side of the palm just below
the index finger. The mean hand legnth of the subjects
D. Odell and P. Johnson / Evaluation of flat, angled, and vertical computer mice 247
was 18.1 cm (range 16.6 to 20.1 cm) and the mean hand
breadth was 8.8 cm (range 7.6 to 9.6 cm). Using US
anthropometric data as a reference [30], hand lengths
spanned from the 18%tile female to the 86%tile male and
hand breadths spanned from the 37%tile female to the
96%tile, so a wide hand size range was represented.
2.2. Mouse models evaluated
Theexperimentwasarepeated measuresdesignwhere
subjects performed a series of standardized point-and-
click tasks with five different mice (Fig. 1). The five
models consisted of two benchmarks (Models E and F)
and three concept mice (Models H, I and J). The two
benchmarks were cast models of the Evoluent™Vertical
mouse (Model E), and the more traditional right-handed
mouse, the Microsoft IntelliMouse Explorer for Blue-
tooth (Model F). All tested mice were cast models made
out of BJB TC182 castable foam. The cast models were
made functional by harvesting wireless optical track-
ing sensors from commercially manufactured mice and
inserting them into the cast mouse bodies. All models
where made of the same materials, finishes, and track-
ing engines to minimize confounding factors. The left
buttons on the mouse models were made operational by
installing and connecting a tactile switch under the flex-
ible button surface.
The bodies of the three concept mice were similar in
design. They were all approximately 61 mm wide and
60 mm tall at the highest point on the left mouse but-
ton and the topcases were angled roughly 20 degrees
downward relative to a horizontal plane. The topcase
slope and extra height was designed to help reduce
forearm pronation. The concept mice all had thumb
grooves roughly 25 mm off of the table surface with
Model E Model F Model H Model I Model J
Fig. 1. Top and rear view images of the mouse models tested. Model
E (benchmark vertical mouse), Model F (benchmark flat mouse), and
the three concept mouse designs - Model H, Model I and Model J.
the thumb groove for Model ‘I’ being slightly lower
and less distinct.
The primary differences between the concept mice
were the overall length and the design of back of the
mouse where the thumb and palm of the hand rested.
Model H was the shortest (105 mm), ball-like in shape
and afforded the most flexibility in grip styles. Model
I was the longest (130 mm) and had a large flange sup-
porting the base of the thumb. Model J was a hybrid of
Model H and I, intermediate in length (120 mm) with a
smaller flange for the base of the thumb.
2.3. Experimental procedures
The test workstation was set up according to ANSI
HFS 100 standards [2] to match the subject’s stature.
Subjects were allowed to make slight adjustments in
table and chair height for comfort. Mouse performance
was measured while subjects performed a series of
standardized point-and-click tasks, as specified in the
international standards for evaluating pointing device
performance [29]. These tasks consisted of a series
of omni-directional pointing tasks which consisted
of alternately clicking on 18 evenly spaced round
targets arranged in a circle (Fig. 2). As illustrated in
Fig. 2, to perform the tasks, subjects would move the
cursor with the mouse and click on the first active,
black-highlighted target, the target would disappear,
and then the target on the diametrically opposite side
of the circle would become active, and the subject
had to move the mouse to acquire this target and
then click on it. This sequence continued until all 18
targets had been acquired. The series of tasks consisted
of performing: 1) six large pointing tasks requiring
gross movements with a center-to-center inter-target
distance of 142 mm and target width of 12 mm - this
target size was similar to the size of folders and icons
on a computer desktop; 2) six medium pointing tasks
requiring intermediate movements with a center-to-
center inter-target distance of 71 mm and target width
of 6 mm - half the size of the large targets and twice the
size of the small targets; and 3) three small pointing
tasks requiring fine movements with a center-to-center
inter-target distance of 28 mm and target width of
2 mm - these small targets approximated the size of
individual characters. The small, medium and large
tasks all had the same index of difficulty according to
Fitt’s Law [7].
While performing the point-and-click tasks, subjects
were instructed to move the mice as fast as possible
while maintaining a balance between speed and accu-
248 D. Odell and P. Johnson / Evaluation of flat, angled, and vertical computer mice
Fig. 2. Large, medium and small omni-directional pointing tasks. The numbers in large pointing task on the left shows the sequence of the pointing
racy. Using a different traditional mouse than the one
tested in the study, subjects were allowed to practice
the tasks (typically 2 to 4 minutes) until they were
comfortable with the how to complete the various tasks.
Mouse model and task order were randomized and no
instructions were provided as to how to grip or use the
2.4. Forearm and wrist posture
Right hand wrist angles were measured using an
electrogoniometer (Model XM-65; Biometrics; Gwent,
UK), forearm pronation/supination was measured with
an inclinometer (FAS-G; Microstrain, Inc.; Williston,
VT) mounted to the distal end-block of the elec-
trogoniometer, and all measures were collected and
stored at 100 Hz on a portable data logger (Muscle
Tester ME6000; Mega Electronics; Kuopio, Finland).
As prescribed by the American Academy of Orthopedic
surgeons [9], the neutral flexion/extension (F/E) posi-
tion of the wrist was defined at the position where the
horizontal plane formed by the back of the hand was
in line with the plane formed by the back of the fore-
arm. The neutral radial/ulnar (R/U) position was defined
as the position where the third metacarpal was in line
withthelongaxis of theforearm.Thiscalibration posture
accounted for and minimized any offset errors associ-
ated with forearm pronation [14]. With the inclinome-
ter, subjects alternated between a hand-shake position
with their hands perpendicular to the worksurface (0º)
and a fully pronated position with their palms parallel to
the worksurface (90º). Pronation/supination (P/S) mea-
surements were relative to the neutral position (0º).
2.5. Perceived fatigue and preference
Perceived fatigue levels while using each mouse
model were measured in the right hand, forearm, shoul-
der and neck using visual analog BORG CR-10 scales
[3] administered before and after using each mouse.
Before using the mice, subjects were asked to give
their preliminary preferences based on visual appear-
ance and touch. Then, after completing the series
of omni-directional point-and-click tasks with each
mouse, a series of eight mouse preference questions
were answered. These questions employed a 7-point
Likert scale ranging from 1- Strongly Disagree to 7-
Strongly Agree. Finally, after using all mouse models,
the participants ranked their final mouse preferences.
2.6. Data and statistical analysis
With the inclinometer and goniometry data, mean
postural values were calculated for each subject
and then group mean postural values were calcu-
lated for Pronation/Supination, Flexion/Extension and
Radial/Ulnar deviation. A program written in Labview
calculated movement times between targets in seconds
and the number of missed targets per trial. To reduce any
additive effects of time, Borg scale rating data were nor-
malized to the initial measurement so that comparisons
between mice could be made. Normalization involved
subtracting the Borg scale rating at the initial measure-
ment from end measurements, thus, the change in Borg
scale ratings relative to the initial measurement were
being compared. All posture, performance, perceived
fatigue and preference data were then tabulated and
analyzed using repeated measures analysis of variance
D. Odell and P. Johnson / Evaluation of flat, angled, and vertical computer mice 249
(RANOVA) methods using the statistical program JMP
(Version 7.0; SAS Institute; Cary, NC). Data are pre-
sented as means and standard error and differences were
considered to be significant when p-values were less
than 0.05.
3. Results
3.1. Posture
There were postural differences between the five
mouse models tested, and average postures during the
performance of the point-and-click tasks are summa-
rized in Table 1. Model E, the vertical benchmark
mouse, was operated with the greatest amount of wrist
extension and the least amount of hand/forearm prona-
tion. Model F, the flat benchmark mouse, required the
greatest amount of ulnar deviation and hand/forearm
pronation. Concept Model I was operated with the least
amount of extension and Concept Model J the least
amount of radial/ulnar deviation. On average, compared
to the flat benchmark mouse (Model F), the concept
mouse designs (Models H, I and J) reduced prona-
tion by 13.1±1.0, ulnar deviation by 6.9±1.5and
increased extension by 1.6±1.8.
3.2. Performance
As shown in Table 2, during the performance
of the omni-directional point-and-click tasks, there
were movement time differences between the five
mouse models tested (p= 0.02). Subjects consistently
performed tasks the slowest with vertical benchmark
mouse (Model E). There were only small differences in
movement times between the concept mouse designs
(Models H, I and J) and the flat benchmark mouse
(Model F). Despite the tasks having the same index of
difficulty, there were movement time differences based
on task size (p< 0.01) but there was no difference by
task size interaction (p= 0.53). Depending on the mouse
model, the smaller tasks took 10 to 20% longer to com-
plete. There was also an order (p< 0.01) and trial effect
(p< 0.01). When cycling through the five mouse mod-
els, the subject’s movement times were progressively
faster with each subsequent mouse. With respect to tri-
als, movement times decreased from the first to second
trial (p< 0.01) but then were relatively stable for the
remaining four trials.
Table 3 shows the accuracy of the mice in the form
of number of missed targets. No statistically significant
differences were found for missed targets.
3.3. Perceived fatigue and subjective preference
On average, the time to complete the suite of tasks
with each mouse was 4 minutes. Table 4 shows the
changes in perceived fatigue by body region after the
4 minutes of mouse use. In general, changes in per-
ceived fatigue were small and mouse Model H had the
lowest perceived fatigue levels for the concept mouse
designs (Models H, I and J). Mouse Model H scored
favorably in three out of four body locations while the
vertical benchmark mouse (Model E) was rated as the
least fatiguing in the wrist and shoulder regions.
Table 1
Mean (standard error) posture with each mouse. Means with different superscripts are significantly different [N= 12].
Lower values are generally preferred for more neutral postures
Benchmark Mice Concept Mice p-value
Vertical Flat
Model E Model F Model H Model I Model J
Extension 41.2a(±3.0) 36.1a,b(±3.4) 40.7a(±3.0) 35.0b(±3.3) 37.4a,b(±3.5)p= 0.004
Ulnar(+)/Radial(-) Deviation 3.9a,b(±3.0) 8.1b(±3.9) 1.6a(±3.7º) 2.1a(±3.2) –0.2a(±3.1)p< 0.0001
Pronation 40.4a(±2.1) 70.5b(±2.4) 61.3c(±2.5) 56.4d(±2.4) 54.5d(±2.1)p< 0.0001
Table 2
Mean (standard error) movement times in seconds by mouse model while performing the large, medium and small omni-directional
point-and-click tasks. Means with different superscripts are significantly different [N= 12]. Lower values are preferred for faster task completion
Vertical Flat Concept Mice p-value
Model E Model F Model H Model I Model J
Large Task 1.04a(±0.07) 0.89b(±0.07) 0.91a,b(±0.07) 0.92a,b(±0.05) 0.87 b(±0.06) p= 0.02
Medium Task 1.03a(±0.06) 0.88b(±0.07) 0.88b(±0.06) 0.91a,b(±0.06) 0.90 a,b(±0.07) p= 0.02
Small Task 1.21 (±0.12) 1.04 (±0.11) 0.99 (±0.07) 1.00 (±0.08) 1.04 (±0.06) p= 0.09
250 D. Odell and P. Johnson / Evaluation of flat, angled, and vertical computer mice
Table 3
Mean (standard error) number of missed targets (out of 18 targets) by mouse model while performing the large, medium and small
omni-directional point-and-click tasks. [N =12]. Lower values are preferred for higher accuracy
Vertical Flat Concept Mice p-value
Model E Model F Model H Model I Model J
Large Targets 1.0 (±0.1) 0.7 (±0.1) 1.1 (±0.2) 1.1 (±0.2) 1.0 (±0.2) p= 0.31
Medium Targets 1.5 (±0.2) 1.3 (±0.2) 1.7 (±0.2) 1.6 (±0.2) 1.4 (±0.3) p= 0.51
Small Targets 3.1 (±0.4) 2.8 (±0.4) 3.3 (±0.3) 2.7 (±0.3) 3.6 (±0.4) p= 0.21
Table 4
Mean (standard error) change in Borg CR-10 scale ratings after using each mouse by body region. The larger the number the more fatiguing
mouse use was perceived to be [N= 12]
Vertical Flat Concept Mice p-value
Model E Model F Model H Model I Model J
Hand 0.64 (±0.25) 0.46 (±0.38) 0.00 (±0.22) 0.30 (±0.13) 0.75 (±0.26) p= 0.11
Wrist 1.00 (±0.50) 0.28 (±0.31) 0.21 (±0.34) 0.96 (±0.36) 0.53 (±0.26) p= 0.32
Forearm 0.74 (±0.33) 0.58 (±0.29) 0.15 (±0.16) 0.79 (±0.35) 0.77 (±0.27) p= 0.36
Shoulder 0.90 (±0.28) 0.01 (±0.28) 0.08 (±0.17) 0.62 (±0.44) 0.57 (±0.26) p= 0.15
Prior to the pointing tasks, the mice were ranked to
determine preferences based on feel and appearance and
the flatbenchmark mouse (Model F) was the most pre-
ferred mouse (Table 5). After subjects had performed
the pointing tasks with all of the mice, the models
were ranked again. After use, mouse Model F was still
the most preferred mouse but mouse Model H had the
greatest change in preference, starting as the 4th most
preferred mouse and ending as the 2nd most preferred
mouse. The vertical benchmark mouse (Model E) was
the least preferred both pre and post use.
Table 6 shows that there were significant differences
in preference across the mice tested. The flat bench-
mark mouse (Model F) received the most favorable
response in all 8 questions while concept mouse Model
H had the second most favorable response in 7 out of
8 questions and had the highest ratings of the concept
mouse models. The vertical benchmark mouse (Model
E) received the least favorable responses in all eight
4. Discussion
4.1. Posture
The concept mice (Models H, I and J) promoted more
neutral hand/forearm pronation and radial/ulnar devia-
tion postures compared to the flat benchmark mouse
(Model F). Mouse Models F, I, and J all had similar
wrist extension values (average 36), whereas Models
H and E had slightly higher values for wrist extension
(average 41). The vertical benchmark mouse (Model
E) had the greatest effect on reducing pronation.
As mentioned in the methods section, no instructions
were given on how to use or hold any of the concept
mice. These mice were designed so the front of the
mouse would point slightly inward towards the center-
line of the user’s body if held with no inward/outward
rotation of the arm and the wrist in a neutral radial/ulnar
posture. Most subjects were observed to not hold the
mouse with the front pointing in as designed, but rather
with the front of the mouse parallel to the right edge of
the keyboard, a posture which required more ulnar devi-
ation and extension than intended orientation/posture.
So, it seems that ulnar deviation and wrist extension
may be further reduced with some instruction on how to
position and hold the mouse, and this has been verified
in other work [11].
4.2. Performance
All of the mice used identical optical tracking
engines, so the observed performance differences are
attributable to the differences in shape/design of the
mice. The flat benchmark mouse (Model F) and the
concept mice (Models H, I, J) had similar pointing
times during the performance of the point-and-click
task. However, the vertical benchmark mouse (Model
E) was significantly slower than the other four mice.
The fact that the concept mice performed as well
as the flat benchmark mouse in pointing performance
was encouraging from a design standpoint. The lack
D. Odell and P. Johnson / Evaluation of flat, angled, and vertical computer mice 251
Table 5
Preliminary mouse model preferences before use and final mouse model preferences post-use. Bottom row is the mean rank for each mouse
model [N =12]. Lower values represent stronger preference
Preliminary Final
Vertical Flat Concept Mice Vertical Flat Concept Mice
Model E Model F Model H Model I Model J Model E Model F Model H Model I Model J
1st 17211 1st 18111
2nd 0 4 2 3 3 2nd 0 0 7 3 2
3rd 0 0 2 3 7 3rd 2 4 2 1 3
4th 1 1 6 4 0 4th 1 0 1 5 5
5th 10 0 0 1 1 5th 8 0 1 2 1
Mean Rank 4.6 1.6 3.0 3.1 2.7 Mean Rank 4.2 1.7 2.5 3.3 3.2
Table 6
Mean (standard error) responses to mouse preference questions using a 7-point (1 =Strongly Disagree, 7 = Strongly Agree) Likert scale. Scores
within each row with the different superscripts are significantly different [N= 12]. Higher values represent stronger preference
Vertical Flat Concept Mice
Model E Model F Model H Model I Model J p-value
1. This mouse was easy to use 3.3a(±0.54) 5.7b(±0.31) 5.2b(±0.27) 4.4a,b(±0.50) 4.4a,b(±0.47) p= 0.004
2. This mouse feels comfortable 3.0a(±0.49) 5.5b(±0.31) 4.8b,c(±0.35) 3.6a,c(±0.48) 3.7a,c(±0.53) p= 0.002
3. The overall shape of this mouse looks appealing. 3.3a(±0.49) 5.4b(±0.34) 4.3a,b(±0.41) 4.8b(±0.32) 4.3a,b(±0.46) p= 0.004
4. It was hard to make errors using this mouse 3.0a(±0.43) 5.2b(±0.47) 3.9a,b(±0.47) 3.5a,b(±0.52) 3.6a(±0.36) p= 0.006
5. I like using this mouse. 2.8a(±0.55) 5.3b(±0.38) 4.3a,b(±0.37) 3.8a(±0.45) 3.8a,b(±0.54) p= 0.001
6. I can quickly complete tasks using this mouse. 3.2a(±0.47) 5.4b(±0.42) 4.2a,b(±0.44) 3.8a(±0.46) 4.0a,b(±0.46) p= 0.003
7. I quickly adjusted to using this mouse. 4.1a(±0.54) 6.0b(±0.41) 5.1a,b(±0.36) 4.4a,b(±0.45) 4.4a,b(±0.47) p=0.02
8. I would buy this mouse. 2.7a(±0.61) 5.2b(±0.39) 3.4a,b(±0.56) 3.0a(±0.52) 2.9a(±0.42) p= 0.005
Average 3.2 5.5 4.4 3.9 3.9
of the performance decrement with the concept mice
indicated that it was possible to alter wrist and forearm
posture during mouse use without the negative impact
on performance that has been seen in previous studies
with other alternative mouse [1, 10].
Model E’s relatively slower pointing speed is likely
due to its vertical orientation. The difference was that
mouse Model E primarily required flexion and exten-
sion of the wrist to move the mouse side-to-side. In
contrast, wrist deviation was used to move the tradi-
tional flat mouse side-to-side, and a combination of
wrist deviation and extension was used to move the
concept mice side-to-side. It seems that either this wrist
flexion/extension motion is inherently slower, or some-
thing else (such as the larger size of Model E) accounts
for the reduced pointing speed.
4.3. Subjective preferences
Subjective measures showed preference for the tradi-
tionally designed flat mouse (Model F) both pre and post
mouse use. This is not a surprising finding as this mouse
was chosen as the benchmark due to its high comfort
ratings amongst flat mice, and was most similar to the
traditional mice which participants were most familiar
with. In contrast, the other mouse designs (Models E,
H, I and J) were unfamiliar. Model H ended up as the
second most preferred overall, and the most preferred
of the concept mice. Model H had the greatest change
in preference pre and post use going from the 4th to
the 2nd most preferred mouse. Subjects ranked mouse
Model H as the most preferred concept mouse because,
due to the shorter length and ball shape, this mouse was
the best fit for their hand and was more easily controlled
than the other concept mice. Subjects felt Model I was
too big and Models I and J did not fit their hands as well
as Model H. The vertical benchmark mouse, Model E,
was disliked overall. It was seen as too big, didn’t fit the
hand well, required the most drastic change in control
strategy and was noticably slower and more difficult to
control than the other mice.
4.4. Final mouse selection
In the end, all three concept mice had relatively
similar performance in posture, pointing speed, and
252 D. Odell and P. Johnson / Evaluation of flat, angled, and vertical computer mice
Fig. 3. The commercially manufactured mouse based on concept
mouse Model H.
learning, but one model, mouse Model H, differenti-
ated itself due to more favorable perceived fatigue and
preference ratings. Mouse Model H was also observed
to best accommodate a variety of grip styles. These ben-
efits led to mouse Model H being selected as the final
model for commercial development as the Microsoft
Natural®Mouse 6000/7000 (Fig. 3).
Previous alternative mouse designs have also demon-
strated improvements in posture and discomfort.
However, these alternative mouse designs have often
resulted in reduced pointing performance and/or low
marks for subjective preference [1, 10, 25, 26]. The final
concept mouse model selected from this study reduced
these pitfalls by providing posture and comfort benefits
along with a pointing performance and learning curves
comparable to the commercially sold mice similar to
the flat benchmark mouse (Model F).
It is anticipated that the postural improvements
promoted by the final production mouse will fol-
low the trends of the postural and musculoskeletal
health improvements associated with split keyboard
designs. With split keyboard designs, early research
demonstrated improvements in posture and subjective
comfort [17, 20, 24]. These improvements were later
linked with long term comfort benefits and a reduction
in the risk of musculoskeletal disorders and symptoms
4.5. Study limitations
The main limitation of this study is the short expo-
sure time that each participant had with each mouse –
roughly 4 minutes with each mouse. This means that
only initial performance was captured from users who
were novices with all of the mice, except for the tradi-
tional mouse, Mouse F, was the most familiar. Another
potential limitation, is that only a single Index of Diffi-
culty [16] was used in the pointing performance tasks.
In the future, testing an array of indexes of difficulty
could be desirable.
4.6. Future study directions
The concept mouse design selected for manufacture
and sale was designed to address a number of iden-
tified postural risk factors which may be associated
with intensive mouse use. However, to what degree
this new design will benefit mouse users in the long-
term is a research question that should be answered
by future studies. To best answer the question of long-
term effects, a longitudinal, randomized control trial
that evaluates musculoskeletal symptoms and disorders
with mouse use over an extended period of time would
be desirable. A separate line of research could evaluate
the other biomechanical risk factors addressed by the
design. In particular, muscle loads, carpal tunnel pres-
sure and the contact area/pressure over the hand and
wrist associated with operating the mouse may be worth
evaluating with the new mouse design. It would be
interesting to see if further design modifications might
address the issue wrist extension as described in 4.1.
5. Conclusions
The concept mice in this study offered less pronated
and deviated postures relative to the flat bench-
mark mouse without negatively affecting pointing
performance. These postural benefits were created by
increasing the mouse height and angling the topcases
of the concept mice. In contrast, the vertical bench-
mark mouse was successful in reducing wrist deviation
and forearm pronation, but pointing performance was
adversely affected and preference ratings were lower.
Therefore, some pronation reduction has been shown to
be beneficial. But, it is possible to go too far and nega-
tively affect performance and preference. The concept
mouse with the best overall performance in this study
was selected for commercial production.
D. Odell and P. Johnson / Evaluation of flat, angled, and vertical computer mice 253
Many thanks to Monique Chatterjee for her excellent
design work and collaboration. Thanks to Dick Comp-
ton, Steve Buchanon, Vince Jesus and the Microsoft
modelshopfor generating thefunctionalprototypes used
in this study, and to Jim Ploger, Han Chen and Janet
Blackstone at the University of Washington who ran the
experiments. This study was funded by the Microsoft
Corporation and support was also provided by the Wash-
ington State Medical Aid and Accident Fund.
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... Originally, the computer workstation design only took the keyboard into consideration, but current computer usage requires manual control of the mouse, typically exceeding as much as three times as long as keyboard usage. (Feathers, Rollings, & Hedge, 2013;Odell & Johnson, 2015). The usage of a regular computer mouse forces most users to adopt abnormal or "less ideal" postures for an elongated period of time. ...
... Age inclusion was very similar between studies, with ages ranging from 18 to 52-years old. Eleven out of the 17 articles had an average age of participants less than 35 years (Chen & Leung, 2007;Dehghan et al., 2015;de Korte et al., 2008;Feathers et al., 2013;Jung, 2014;Kumar & Kumar, 2008;Lee et al., 2007;Lin et al., 2015;Odell & Johnson, 2015;Oude Hengel et al., 2008;Quemelo & Vieira, 2013). In addition, 4 of the 17 articles included large age ranges (Houwink et al., 2009;Karsten & Erwin, 2015;Odell & Johnson, 2015;Oude Hengel et al., 2008). ...
... Eleven out of the 17 articles had an average age of participants less than 35 years (Chen & Leung, 2007;Dehghan et al., 2015;de Korte et al., 2008;Feathers et al., 2013;Jung, 2014;Kumar & Kumar, 2008;Lee et al., 2007;Lin et al., 2015;Odell & Johnson, 2015;Oude Hengel et al., 2008;Quemelo & Vieira, 2013). In addition, 4 of the 17 articles included large age ranges (Houwink et al., 2009;Karsten & Erwin, 2015;Odell & Johnson, 2015;Oude Hengel et al., 2008). Research has shown that age can play a role with different computer input devices; middle-aged users tend to be significantly slower than younger users when performing different computer tasks (Armbrüster, Sutter, & Ziefle, 2007). ...
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Prolonged use of a standard mouse is associated with musculoskeletal symptoms. This review provides professionals with in-depth analysis of the literature regarding the evidence behind the use of alternative computer mouse designs and their ability to reduce discomfort in mouse users, in addition to the potential effect of ergonomics training and forearm supports. Multiple data bases were searched by independent researchers to identify 17 high-quality controlled trials including varieties of acceptable mouse designs (vertical, slanted, upright, roller bar, biofeedback and others). Methodological quality of these studies were assessed by independent raters utilizing the PEDro quality assessment scale and the Cochrane Risk of Bias (ROB) scale, and the results revealed that included studies were of moderate quality (5–6/10) and had some intrinsic ROB. It is concluded that there is moderate quality of evidence to support the use of alternative mouse designs to reduce discomfort, promote posture and decrease unnecessary muscle activation, especially if accompanied by appropriate ergonomic training. However, standard mouse still offers appropriate users preference levels. Hence, the consensus is that, mouse selection and purchase should be an individualized process based on individual needs and work demands and that there is no universal model that works well with everyone. © 2018, © 2018 The Author(s). This open access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.
... Johnson [35,36], satisfy the requirements resulting from the operations of this type carried out in the course of the CAD activity. In that study, 12 participants tested the various computer mice during the performance of pointing tasks. ...
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Background: Static muscular activity of muscles activated in the use of the conventional PC mouse is believed to represent a higher risk for the musculoskeletal health of the user than dynamic muscular activity. Objective: This paper presents a compounded muscular activity dynamics indicator (akin to percent relative range), enabling comparison between computer handheld pointing devices. Methods: This muscular dynamism approach considers baseline muscular activity (APL, ECR, ECU and ED) relative to the Maximum Voluntary Contraction as well as the dynamics of muscular activation. The latter is computed as the ratio of the difference between APDF90 and APDF10 divided by APDF50 (APDF-Amplitude Probability Distribution Function for the 90th, 50th and 10th percentiles). The paper demonstrates the approach with results of comparative evaluation of a horizontal, a slanted and a vertical PC mouse, through surface EMG monitoring of 20 participants performing standardized graphical task with the devices. Results: Hand size impacts muscular activity dynamics in these four muscles, which supersedes differences in device geometry, across the range of devices tested. Conclusion: Smaller devices relative to hand size foster more dynamic muscular activity.
... Research in this field was conducted to make people more comfortable in using the mouse and increasing its efficiency. In 2015, Oled and Johnson [18]. evaluated the flat, angular, and vertical mice, and their effects on the position of the wrists, and showed the function and priority of using each one. ...
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Human beings have always made their tools and instruments they need using patterns in nature. Mimicking nature has become the foundation of a new science called Biomimetics. In the present article, multiple forms and levels in nature were utilized to design and create a mouse. The rivers are a good source for choosing the shape of a mouse with lots of stones abraded through the centuries which also have smooth surfaces. In this research, a significant number of stones fitted to hand size were collected and then the best ones were scanned by an optical scanner. The point cloud model obtained was used to design and create the mouse and determine the geometric parameters of the mouse. After extracting the 3D model of the point cloud using a rapid prototyping technique with the Fused Deposition Modeling (FDM) method, some mouse models were designed ambidextrously for left-handed and right-handed people. Considering the results of the mouse evaluation by 30 people who were provided with the mouse, it can be concluded that the created mouse provided a high rate of satisfaction.
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Work is a fundamental axis for the development of societies and human well-being, but if a person cannot adapt to their work area and work environment, the individual may be affected by occupational or coexisting illnesses that get exacerbated when working.A scientific search was conducted in the main health databases - MEDLINE (via PubMed), Web of Science, SciELO, Scopus, Google Scholar, and Dialnet - using the keywords "occupational health", "occupational diseases", "occupational accidents" AND "oral radiology" OR "oral radiologists". Systematic reviews as well as observational, cross-sectional and longitudinal studies were included. Case reports, letters to the editor, editorials, and opinion articles were excluded. In total, 496 articles were recovered, and only 51 fulfilled the selection criteria. Signs and symptoms that affect oral radiologists include back pain, shoulder pain, wrist pain, tenosynovitis, computer vision syndrome (CVS), stress, depression, and burnout syndrome. Preventive occupational health (OH) measures are proposed to help eliminate or alleviate the symptoms associated with non-ergonomic habits at work. Oral radiologists are exposed to several risks and occupational diseases inherent and/or related to their work. By implementing simple habits and ergonomic advice, well-documented in the literature, these risks can be avoided.This review aimed to provide scientific information on the current concepts of OH in oral radiologists in order to help prevent occupational diseases and occupational accidents, and guarantee safe professional practice.
Objective We validated the effect of moveable arm support (Armrest®) on wrist posture during three standardized tasks. Background The use of the computer mouse has been increasing over the years and it has been identified as one of the occupational activities related to carpal tunnel syndrome (CTS). The main mechanism for CTS is carpal tunnel pressure (CTP) that could be estimated from the wrist posture. Method Using an electronic goniometer, we assessed wrist extension/flexion and ulnar-radial flexion in 15 participants (age: 34.8 [8.7] years) and calculated the time the wrist posture was outside the threshold values previously related to CTP. Specifically, we estimated time when wrist posture yielded >25 mmHg of CTP: wrist extension >32.7°; wrist flexion < −48.6°; wrist ulnar flexion >14.5°; and wrist radial flexion < −21.8°. Results Average wrist extension/flexion tends to be 13.4° lower (p = 0.063), while radial-ulnar flexion was 13.2° lower (p = 0.025) when Armrest® forearm support was used in comparison to fixed forearm support. Furthermore, the time spent outside the threshold wrist extension was 25.8% (p = 0.018) lower and ulnar flexion was 37.2% (p = 0.017) lower when using Armrest® compared to a fixed forearm support. Results were independent from tasks. Conclusion Armrest® diminished the time spent outside the threshold values related to 25 mmHg of CTP indicative of CTS. Application A moveable arm support is a simple and effective way to increase occupational health during computer mouse work.
Background: Focusing on the efficiency aspect of computer pointing devices' usability, this paper reports on a novel and tentative empirically derived efficiency index for 3D CAD. Objective: Three commercially available computer pointing devices were compared: a standard horizontal computer mouse, a vertical device (supporting neutral pronation of the forearm) and a slanted device. Methods: Pilot structured observations of 10 subjects' activity were carried out to estimate the proportion of each unique computer mouse operation during CAD modelling with a 3D parametric software. Pointing, dragging and steering standardized tasks were implemented by software and performed by 20 users. Effectiveness and efficiency were calculated and discomfort, effort and ease of use were subjectively assessed. Results: The mean efficiency index value was lower for the vertical device. Assessments of discomfort, effort and ease of use also supported considering preference for the horizontal and slanted devices, providing limited internal validation. Conclusion: Results suggest the tentative index may offer a valid means of ranking performance of alternative pointing devices regarding operation efficiency.
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Objective: to compare the biomechanics and performance while using a vertical computer mouse (VM) and a standard mouse (SM). Methods: muscle activation (electromyography), forearm movements (electrogoniometers), performance (Fitts' Law test) and satisfaction (questionnaire) of 16 subjects were evaluated. Results: there were significant differences between the VM and the SM, respectively, on motion (28° vs. 42° pronation, p = 0.001; 5° ulnar vs. 7° radial deviation, p = 0.016) and muscle activity (13% vs. 16% of extensor carpi activity, p = 0.006; 10% vs. 13% extensor digitorum activity, p = 0.001). VM user satisfaction was good (68); however, time to target was longer (4.2 vs. 3.4 s, p < 0.001). Conclusions: using the VM decreased wrist pronation and lowered wrist extensor muscle activity, but additional training and familiarisation time may be required to improve user performance. Practitioner summary: Using a vertical mouse can decrease the exposure to biomechanical risk factors for computer mouse use-related musculoskeletal disorders. Using a vertical computer mouse resulted in less wrist pronation and lower wrist extensor muscle activity. But, training and familiarisation are required.
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The effects of forearm rotation and metacarpophalangeal (MP) flexion on carpal tunnel pressure were investigated in 17 healthy adults who had no evidence of carpal tunnel syndrome (CTS). Pressure was continuously recorded with a saline-filled catheter inserted into the carpal tunnel and connected to a pressure transducer while test subjects slowly rotated the forearm from full pronation to full supination. Forearm rotation was repeated with MP flexion of 0o, 45o, and 90o. Both forearm rotation and MP flexion, and their interaction term, significantly affected carpal tunnel pressure and accounted for most of the variability in the data. Highest mean pressures (55 mmHg) were recorded in full supination and 90o MP flexion and lowest pressures (12 mmHg) were recorded at 45o pronation and 45o MP flexion. These data may be useful in the design of tasks and hand tools in the management and prevention of CTS.
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In a field study, a newly developed mouse that gives the operator a more neutral forearm position was compared with a traditional mouse using a more pronated forearm. After using the new mouse for 6 months, a significant reduction was reported regarding pain intensity and frequency for wrist/hand, forearm, shoulder, and neck (p £ .009). The control group using the traditional mouse reported only small changes in the pain level (p ³ .24). Total duration of pain the last 6 months was also significantly improved for the shoulder and forearm in the intervention group, whereas no such changes were observed in the control group. These results clearly indicate the importance of using a computer mouse with a more neutral position of the forearm.
The biomechanical benefits (e.g., muscular activity) of slanted ergonomic mice have been comprehensively identified; however, their effects on task performance and subjective responses have not been fully investigated. The present study examined the effects of two slanted mice (slant angle = 30° and 50°) in comparison with a conventional mouse (slant angle = 0°) in terms of task performance (task completion time and error rate) and subjective responses (perceived discomfort score and overall satisfaction score). Experimental results showed that all of the task and subjective measures worsened as the slant angle of the target mice increases. For example, the task completion time (unit: ms) and overall satisfaction score (unit: point) of the 30° slanted mouse (time = 0.71, satisfaction = -0.09) and 50° slanted mouse (time = 0.73, satisfaction = -0.79) significantly deteriorated than the conventional mouse (time = 0.65, satisfaction = 1.21). The slanted mice seem to compromise biomechanical benefits with task performance and subjective responses.
Eighty computer users with musculoskeletal disorders participated in a 6-month, randomized, placebo-controlled trial evaluating the effects of four computer keyboards on clinical findings, pain severity, functional hand status, and comfort. The alternative geometry keyboards tested were: the Apple Adjustable Keyboard™ [kb1], Comfort Keyboard System™ [kb2], Microsoft Natural Keyboard™ [kb3], and placebo. Compared to placebo, kb3 and to a lesser extent kb1 groups demonstrated an improving trend in pain severity and hand function following 6 months of keyboard use. However, there was no corresponding consistent improvement in clinical findings in the alternative geometry keyboard groups compared to the placebo group. Overall, there was a significant correlation between improvement of pain severity and greater satisfaction with the keyboards. These results provide evidence that keyboard users may experience a reduction in hand pain after several months of use of some alternative geometry keyboards. Am. J. Ind. Med. 35:647–661, 1999. Published 1999 Wiley-Liss, Inc.
Background Although visual display terminal (VDT) work has become a common task among office workers, surveys which would help to determine the allowable duration of daily VDT use are limited.Methods We investigated more than 25,000 workers three times over a 3-year period using a self-administered questionnaire. Three factors, namely mental, physical and sleep-related symptoms, were extracted by factor analysis. Adjusted means of each factor score were compared with the duration of daily VDT use by general linear model.ResultsPhysical symptoms score became higher with increasing duration of daily VDT use without a threshold effect. Mental and sleep-related symptom scores of the workers using VDT for more 5 hr/day were significantly higher than that of the groups using VDT for >1, 1–3, and 3–5 hr/day.Conclusions Duration of daily VDT use was linearly related to the physical symptom score, and was non-linearly related to mental and sleep-related symptom score with a threshold effect of 5 hr/day. Am. J. Ind. Med. 42:421–426, 2002. © 2002 Wiley-Liss, Inc.
BackgroundA prospective study of computer users was performed to determine the occurrence of and evaluate risk factors for neck or shoulder (N/S) and hand or arm (H/A) musculoskeletal symptoms (MSS) and disorders (MSD).Methods Individuals (n = 632) newly hired into jobs requiring  ≥ 15 hr/week of computer use were followed for up to 3 years. At study entry, workstation dimensions and worker postures were measured and medical and psychosocial risk factors were assessed. Daily diaries were used to document work practices and incident MSS. Those reporting MSS were examined for specific MSD. Incidence rates of MSS and MSD were estimated with survival analysis. Cox regression models were used to evaluate associations between participant characteristics at entry and MSS and MSD.ResultsThe annual incidence of N/S MSS was 58 cases/100 person-years and of N/S MSD was 35 cases/100 person-years. The most common N/S MSD was somatic pain syndrome. The annual incidence of H/A MSS was 39 cases/100 person-years and of H/A MSD was 21 cases/100 person-years. The most common H/A disorder was deQuervain's tendonitis. Forty-six percent of N/S and 32% of H/A MSS occurred during the first month of follow-up. Gender, age, ethnicity, and prior history of N/S pain were associated with N/S MSS and MSD. Gender, prior history of H/A pain, prior computer use, and children at home were associated with either H/A MSS or MSD.ConclusionsH/A and N/S MSS and MSD were common among computer users. More than 50% of computer users reported MSS during the first year after starting a new job. Am. J. Ind. Med. 41:221–235, 2002. © 2002 Wiley-Liss, Inc.
Computer pointing devices such as the mouse are widely used. Despite this, the relationship between musculoskeletal symptoms and mouse use has not been established. The aim of this cross-sectional study was to determine whether a relationship existed between computer mouse use and musculoskeletal symptoms in a sample of 270 computer mouse users. Factors demonstrating a significant association with symptoms were entered into a step-wise multiple logistic regression, adjusting for age and sex and controlling for potential interdependence between variables. No relationship was found between hours of mouse use per day and reported symptoms. A relationship was found between the variable of arm abduction which is specific to mouse use and symptoms in the neck. Relationships were found between non-mouse-specific risk factors such as stress, screen height and shoulder elevation. The findings of this study support the hypothesis that mouse use may contribute to musculoskeletal injury of the neck and upper extremity. Mouse users are exposed to the same recognised risk factors associated with keyboard use as well as the additional risk factor of arm abduction during mouse use.Relevance to industryComputer keyboard use has been associated with musculoskeletal injuries. Most people now use a pointing device such as the mouse to supplement the computer keyboard. Additional risk factors related to mouse use have the potential to increase prevalence of computer-related injuries.
According to Fitts' law, human movement can be modeled by analogy to the transmission of information. Fitts' popular model has been widely adopted in numerous research areas, including kinematics, human factors, and (recently) human-computer interaction (HCI). The present study provides a historical and theoretical context for the model, including an analysis of problems that have emerged through the systematic deviation of observations from predictions. Refinements to the model are described, including a formulation for the index of task difficulty that is claimed to be more theoretically sound than Fitts' original formulation. The model's utility inpredicting the time to position a cursor and select a target is explored through a review of six Fitts' law studies employing devices such as the mouse, trackball, joystick, touchpad, helmet-mounted sight, and eye tracker. An analysis of the performance measures reveals tremendous inconsistencies, making across-study comparisons difficult. Sources of experimental variation are identified to reconcile these differences.