Work Smart - Feel Good
How do you choose
the right mouse?
A practical overview of the health and performance
effects provided by ergonomic mice.
Introduction
The most commonly used accessory for working with a computer
or laptop is still the mouse. Particularly in work environments,
a mouse is often used and is even a standard device included
at many computer workstations. Various studies confirm these
statements. Following a survey of The Atlantic in 2014 conducted
among almost 300 people, it appeared that more than threequarters had used an external mouse during the previous week.
Due to its frequent use, having a good mouse is essential for
making work on a computer or laptop healthy and comfortable.
There are many different kinds of mice on the market today, most
of which (i.e. the unconventional mice) are also ergonomically
responsible. From vertical, precision and centrally positioned mice
to a pen tablet: How can you choose which mouse is right for you?
This whitepaper provides insight into the effects of ergonomic
mice on health and performance. The first section takes a
close look at European legislation. Next to be addressed, step
by step, are health-related effects, the alternative for the
computer mouse, and performance-related effects. We conclude
with a useful selection guide for determining the ergonomic
mouse that best fits your preferences and mouse use.
2
Work Smart - Feel Good
What does EU legislation say?
European legislation stipulates that a monitor must
be separated from the keyboard. For stationary
computers such as desktops and thin clients, the monitor
and keyboard are already separate elements.
An external mouse
allows you to work
quickly and comfortably
on a laptop.
This is not so, however, with a laptop in which the monitor
and keyboard are a single unit. To comply with the legislation,
one should use a separate keyboard when working on a
laptop. It is also necessary to use a laptop stand to enable
placing the monitor in any position. Because the mouse
in the touchpad is an immovable element in a laptop, it is
placed between the monitor and the keyboard, which makes
using it inconvenient, unless an external mouse is used. An
external mouse is thus a logical choice when considering the
standpoint of legislation. And from the user’s standpoint, it’s
necessary for working comfortably and quickly on a laptop.
3
Work Smart - Feel Good
Health effects
Prolonged use of a mouse can result in pain and discomfort
in the shoulders, forearms and hands (Chang, et al., 2007;
Andersen, et al., 2008). Using an ergonomic mouse can help
to counteract these effects and results in more comfort.
4
Work Smart - Feel Good
Hand, wrist and forearm strain
Using a conventional (standard) mouse places the hand, wrist and
forearm in an unfavourable position. The use of a conventional
mouse puts additional strain on the body in three ways:
1. Pronation
Pronation of the forearm occurs when the palm of the
hand is turned inward from its neutral starting position.
Supination
Neutral
Pronation
During this movement, the bones in the forearm and
their attached muscles cross each other as shown
below. This results in increased muscle tension.
A
B
5
Work Smart - Feel Good
2. Wrist extension
Due to the normal height of the mouse, the wrist is
bent backward, this is known as ‘wrist extension’. Since
the user also has to lift the forefinger in order to click,
this increases the strain throughout the wrist area.
3. Ulnar and radial deviation
The most commonly used way of holding a conventional
mouse involves ‘ulnar deviation’. This means that the hand is
turned in the direction of its little finger as shown below. The
degree to which we can turn our hand towards our thumb
(radial deviation) is much more limited. This means that the
hand is usually turned to the right: ulnar deviation. In this
position, the wrist is not often in a neutral position when using
a conventional mouse. Over time, this will lead to strain.
6
Work Smart - Feel Good
Various kinds of ergonomic mice
There are various ergonomic mice that increase the
comfort of using a mouse. All three mice described
below also reduce pronation, wrist extension and
ulnar deviation to one extent or another.
Centrally positioned mice:
roller bar mice and touchpad
The advantage of centrally positioned mice is that they are
located directly in front of the user: between the user and the
keyboard. This results in less muscle strain in the shoulder as
compared to a conventional mouse which is located beside
the keyboard. When using a central mouse, the shoulder
does not have to be turned outward (Lin, et al., 2014).
In addition, the forearms engage in less muscle activity than
when using a conventional mouse (Lin, et al., 2014). There are
two reasons for this. First of all, the wrist is bent backwards
more when using a conventional mouse, so this involves wrist
extension. The fingers are also extended almost as far as possible
so that the user has to click from this position. Since a central
mouse does not force this position, the result is less muscle strain.
7
Work Smart - Feel Good
Pen tablet and other precision-grip mice
A pen mouse as well as various other mice can be held
with the fingertips. When using these mice, the fingers are
often held at a tighter angle while the backward bending
of the wrist is actually decreased, as shown below.
A precision-grip
mouse results in
less muscle strain
The pen mouse and precision-grip mice thus offer about the
same advantages as centrally positioned mice. The use of a
precision mouse can also result in less muscle strain in the
forearms because this involves less wrist extension (Kotani &
Horii, 2003; Ulmann, et al., 2003). When it comes to the shoulders,
however, there is no difference in muscle strain. After all, this
kind of mouse, like a conventional mouse, is often placed next
to the keyboard (Müller, et al., 2010; Kotani & Horii, 2003).
8
Work Smart - Feel Good
Vertical mice
Vertical mice such as the handshake and joystick mice are
grasped in a ‘handshake’ position, as shown below. This
position keeps the wrist from bending as much to the side
while the forearm also turns inward to a lesser degree.
In other words, using a vertical mouse decreases ulnar
deviation and pronation (Schmid, et al., 2015). This means
that muscle activity in the forearm is less than it would be
when using a conventional mouse (Quemelo & Vieira, 2013).
Research has shown that the use of a vertical joystick
mouse ensures a faster recovery of forearm, wrist and
hand complaints (Aarås, et al., 2001). Whether this is
the case for all vertical mice, however, is unknown.
9
Work Smart - Feel Good
The positioning of the mouse
Not only do the shape and the way of controling
the mouse have an effect on posture but so does
the position of the mouse on the desktop.
The numeric keypad included in a traditional full-size
keyboard greatly increases its width, while a large percentage
of computer users use this part of the keyboard scarcely
if at all. The width of the keyboard keeps the mouse
from being positioned in line with the shoulder and thus
impairs the user’s working posture. Compact keyboards
without a numeric keypad reduce the reaching distance to
the mouse and thus decrease strain on the shoulder and
forearm, which, in turn, helps to achieve good posture.
10
Work Smart - Feel Good
Alternatives to the use of mice
Using a mouse is not always the most efficient way of carrying
out computer tasks. Tasks can be carried out on an average of
Cutting mouse use
in half results in
a production gain
of 20 minutes
30% faster, for example, by using shortcut keys (Lane, et al., 2005
/ Tak, 2007). There are also indications that the use of shortcut
keys can enhance work comfort and that users go home in fitter
condition if they use more shortcut keys (Blok, et al., 2008). This
makes shortcut keys a good solution for consistently reducing
mouse use and also for working faster and more efficiently.
Studies have shown that the average computer user is using
the mouse for about half the time spent at the computer. To
be precise, this is even 53% (IJmker, et al., 2011). By cutting
mouse use in half, the user can achieve a production gain of 20
minutes a day. The use of mice will always be necessary, however,
because many of the latest applications would be limited or even
impossible to use due to the lack of the right shortcut keys.
11
Work Smart - Feel Good
Performance effects
Research has demonstrated that a mouse on a laptop leads
to a definite improvement in performance (Sommerich, et al.,
2002). For more information about this, please refer to our
whitepaper entitled ‘How to work comfortably with a laptop?’.
Replacing a conventional mouse with an ergonomic one will
subsequently make a considerable improvement in comfort but
will simultaneously decrease performance. Although using an
ergonomic mouse is often healthier for you, you cannot work
quite as quickly with it as you can with a conventional mouse.
Scott Mackenzie at York University in Canada convincingly
demonstrated the lower speed of an ergonomic mouse. He
had subjects conduct the same kind of mouse operation many
times. Although they increased their speed by practicing with
the touchpad and joystick mouse, the graph below shows that
their speed was fastest with a conventional mouse, followed
by a touchpad and a joystick (MacKenzie, et al., 2001).
Joystick
Touchpad
Time needed
Standard Mouse
Graph 1
The time needed to complete a mouse
task given various kinds of mice.
Reference: Mackenzie, et al., 2001.
0
Number of times practiced
750
12
Work Smart - Feel Good
Performance effects provided
by ergonomic mice
Ergonomic mice are thus somewhat slower to use than
a conventional mouse. The difference in performance
effect, however, depends on the kind of mouse.
Centrally positioned mice:
the roller bar mouse and the touchpad
Studies other than Mackenzie’s also confirmed that a touchpad
is definitely slower than a conventional mouse. Depending on
the task being carried out, the time needed to accomplish it
with a touchpad took at least 25% longer (Hertzum & Hornbaek,
2010; Lee & Su, 2008). This is because using a touchpad requires
more than a single movement to carry out the task. The same
is true of a central roller bar mouse and a trackball mouse.
13
Work Smart - Feel Good
Pen tablet and other precision mice
When it comes to carrying out mouse tasks, pen tablets are
slower than conventional mice (Müller, et al., 2010). For tasks
demanding a high level of precision (e.g. editing photos),
however, a pen mouse is faster than a conventional mouse
(Chen, et al., 2011). People quickly get used to working with a
pen and tablet. After one day of practice, their performance
using a pen and tablet equals that of a conventional mouse
(Kotani & Horii, 2003). It should also be noted, however, that
the tasks in this study were limited to mouse operations.
This is not like everyday computer use in which keyboard
and mouse operations are constantly alternating. After all,
picking up a pen takes more time than grasping a mouse.
Vertical mice
A handshake mouse (a vertically positioned mouse) is 10 to
19% slower than a conventional mouse (Quemelo & Ramos
Vieira, 2013; Scarlett, et al., 2005) but is still considerably
faster than a joystick mouse (Scarlett, et al., 2005).
Editing images
with a pen mouse
takes less time
14
Work Smart - Feel Good
Selection guide
Deciding on the right mouse involves various factors. One
of these is how the mouse is being used. Some employees
require a high degree of precision in using their mouse
while others work on much less precise tasks. Another
factor is personal preference. In general, users consider
the following elements when selecting a computer mouse:
user convenience, physical comfort and precision.
This selection guide makes it easier to select
the mouse that is just right for you.
Advice
Vertical grip
Vertical joystick
Precision grip
Pen tablet
Roller bar
Conventional
Reduces strain
Precision
User convenience
Wrists
Arms
++
++
Wrists
Arms
--
-
Wrists
Arms
++
+
Wrists
Arms
+
-/+
Wrists
Arms
Hands
Shoulders
-/+
-
None
++
++
Evoluent
Anir
DXT
Office 54
Pen tablet
Barmouse
Lasermouse
design
15
Work Smart - Feel Good
About BakkerElkhuizen
Contact details:
BakkerElkhuizen develops excellent products
BakkerElkhuizen International B.V.
for making computer use healthy and efficient.
Palmpolstraat 27
1327 CB ALMERE
Products from BakkerElkhuizen display the perfect
The Netherlands
combination of function, ergonomics and design.
Tel. +31 36 546 7265
E-mail: info@bakkerelkhuizen.com
BakkerElkhuizen advises and helps companies equip their
Website: www.bakkerelkhuizen.com
workplace, including offices that use telecommuting
and flexible working, so that each workstation receives
the right solution and the right accessories.
BakkerElkhuizen bases this on four workstation concepts:
- permanent workstation
- mobile workstation
- flexible workstation
- home workstation
The point of departure is that an employee must be able to
perform his or her computer work comfortably, healthily
and efficiently wherever he or she works. People come
We want to share our knowledge:
first in everything that BakkerElkhuizen does, whether it
Subscribe here to our newsletter
concerns developing new products, performing research
or cooperating with suppliers, resellers and customers.
We would like to help you!
We enjoy giving you the best possible
advice, and because everyone and every
organisation is unique, our specialists give
tailored advice.
Are you looking for a reseller of our
products?
Phone us (+31 36 546 7265) or send us a
short e-mail (info@bakkerelkhuizen.com)
with your question or problem and we will
contact you within 24 hours with the right
advice for you.
16
Work Smart - Feel Good
References
•
Aarås A, Dainoff M, Ro O, Thoresen M, ‘Can a More Neutral Position of the
Forearm When Operating a Computer Mouse Reduce the Pain Level for
Visual Display Unit Operators? A Prospective Epidemiological Intervention
Study: Part II’, International Journal of Human-Computer Interaction. 2001;
13(1): 13–40.
•
Andersen JH, Harhoff M, Grimstrup S, Vilstrup I, Lassen CF, Brandt LP, Kryger
AI, Overgaard E, Hansen KD, Mikkelsen S. Computer mouse use predicts
acute pain but not prolonged or chronic pain in the neck and shoulder.
Occup Environ Med. 2008 Feb;65(2):126-31.
•
Blok MM, Vink P, Van Lingen P. Implications for Health and Performance
when Replacing Mouse Use with Shortcut Keys. In; Karwowski W, Slavendy
G. Conference Proceedings, 2nd International Congress on Applied Human
Factors and Ergonomics. AHFE 2008, 14-17 July 2008, Las Vegas, USA.
•
Chang CH, Amick BC 3rd, Menendez CC, Katz JN, Johnson PW, Robertson
M, Dennerlein JT. Daily computer usage correlated with undergraduate
students’ musculoskeletal symptoms. Am J Ind Med. 2007 Jun;50(6):481-8.
•
Chen JY, Seagull FJ, Nagy P, Lakhani P, Melhem ER, Siegel EL, Safdar NM.
Computer input devices: neutral party or source of significant error in
manual lesion segmentation? J Digit Imaging. 2011 Feb;24(1):135-41.
•
Council Directive 90/270/EEC of 29 May 1990 on the minimum safety and
health requirements for work with display screen equipment (fifth individual
Directive within the meaning of Article 16 (1) of Directive 89/391/EEC).
•
Van Eerd D, Munhall C, Irvin E, Rempel D, Brewer S, van der Beek AJ,
Dennerlein JT, Tullar J, Skivington K, Pinion C, Amick B. Effectiveness
of workplace interventions in the prevention of upper extremity
musculoskeletal disorders and symptoms: an update of the evidence. Occup
Environ Med. 2016 Jan;73(1):62-70.
•
Hertzum, M, Hornbæk, K. How Age Affects Pointing with Mouse and
Touchpad: A Comparison of Young, Adult, and Elderly Users. International
Journal of Human-Computer Interaction. 2010; 26(7):703-734.
•
Ijmker S, Huysmans MA, van der Beek AJ, Knol DL, van Mechelen W, Bongers
PM, Blatter BM. Software-recorded and self-reported duration of computer
use in relation to the onset of severe arm-wrist-hand pain and neck-shoulder
pain. Occup Environ Med. 2011 Jul;68(7):502-9.
•
Kotani K and Horii K. An Analysis of Muscular Load and Performance in Using
a Pen-tablet System, J Physiol Anthropol. 2003;22 (2): 89–95.
•
Lane DM, Napier HA, Peres SC, Sándor A. Hidden Costs of Graphical User
Interfaces: Failure to Make the Transition from Menus and Icon Toolbars to
Keyboard Shortcuts. International Journal of Human-Computer Interaction.
2005;18(2):133-144.
•
Lee YH, Su MC. Design and validation of a desk-free and postureindependent input device. Appl Ergon. 2008 May;39(3):399-406.
•
Lin MY, Young JG, Dennerlein JT. Evaluating the effect of four different
pointing device designs on upper extremity posture and muscle activity
during mousing tasks. Appl Ergon. 2015 Mar;47:259-64.
•
MacKenzie IS, Kauppinen T, Silfverberg M. Accuracy measures for evaluating
computer pointing devices. Proceedings of the ACM Conference on Human
17
Work Smart - Feel Good
Factors in Computing Systems. 2001: 9-16.
•
Müller C, Tomatis L, Läubli T. Muscular load and performance compared
between a pen and a computer mouse as input devices. International
Journal of Industrial Ergonomics. 2010; 40(6):607-617.
•
Quemelo PR1 Vieira ER. Biomechanics and performance when using a
standard and a vertical computer mouse. Ergonomics. 2013;56(8):1336-44.
•
Scarlett DS, Bohan M, Io L, Jorgensen M, Chaparo A. Psychophysical
comparison of five mouse designs. HCI International 2005: The 11th
international Conference on Human-Computer Interaction. Las Vegas. 2005.
•
Schmid AB, Kubler PA, Johnston V, Coppieters MW. A vertical mouse
and ergonomic mouse pads alter wrist position but do not reduce carpal
tunnel pressure in patients with carpal tunnel syndrome. Appl Ergon. 2015
Mar;47:151-6.
•
Sommerich, CM, Starr, H, Smith, CA, Shivers. Effects of notebook computer
configuration and task on user biomechanics, productivity, and comfort.
International Journal Industrial Ergonomics. 2002; 30: 7-31.
•
Tak S. The Use of Keyboard Shortcuts. Optimizing versus satisficing in the
use of complex technology. PhD thesis. Eindhoven University of Technology,
2007.
•
Ullman J, Kangas N, Ullman P, Wartenberg F, Ericson M. A new approach to
the mouse arm syndrome. Int J Occup Saf Ergon. 2003;9(4):463-77.
18
Work Smart - Feel Good