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CHI 2008 Proceedings · Personal Health                                                                   April 5-10, 2008 · Florence, Italy



                          SuperBreak:
   Using Interactivity to Enhance Ergonomic Typing Breaks
                                   Dan Morris, A.J. Bernheim Brush, and Brian R. Meyers
                                                     Microsoft Research
                                                    Redmond, WA, USA
                                          {dan,ajbrush,brianme}@microsoft.com
ABSTRACT                                                                          any time there is repeated motion of a muscle group under
Repetitive strain injuries and ergonomics concerns have                           strain without rest, the potential for injury exists [19].
become increasingly significant health issues as a growing
number of individuals frequently use computers for long                           Continuous keyboard and mouse use create precisely this
periods of time. Currently, limited software mechanisms                           scenario for information workers. A literature review [2]
exist for managing ergonomics; the most well-known are                            shows numerous studies linking the use of keyboard and
“break-reminder” packages that schedule and recommend                             mouse to RSI. We can expect these problems to be magni-
typing breaks. Yet despite the proven benefits of taking                          fied tremendously as the current generation of children and
breaks, such packages are rarely adopted due to the over-                         teenagers – for whom computer use has been a daily activi-
head of introducing periodic interruptions into a user’s                          ty since early childhood – enters the information workplace.
workflow. In this paper, we describe SuperBreak, a break-                         These individuals have not only been subject to more long-
reminder package that provides hands-free interactions dur-                       term damage due to a lifetime of computer use, but are
ing breaks, with the goal of encouraging users to take more                       combining full days of office computer work with home
breaks and enhancing the benefits of those breaks. In a field                     computer use, which renders them more susceptible to RSI
study of 26 knowledge workers, 85% preferred SuperBreak                           and other health problems caused by extensive typing and
over a traditional break-reminder system, and on average                          mousing. The U.S. Department of Labor, Occupational
participants took a higher percentage of the interactive                          Safety and Health Administration (OSHA) states [18] that
breaks suggested to them. Our results highlight the value of                      “performing this task [computer use] for several uninter-
interactivity for improving the adoption and retention of                         rupted hours can expose the small muscles and tendons of
ergonomic break practices.                                                        the hand to hundreds or even thousands of activations.
                                                                                  There may not be adequate time between activations for
Author Keywords                                                                   rest and recuperation, which can lead to localized fatigue,
Ergonomics, RSI, interruptions, physical interfaces                               wear and tear, and injury.” OSHA has issued a set of rec-
ACM Classification Keywords                                                       ommendations including, among other things, the follow-
H5.2 [Information interfaces and presentation]: User Inter-                       ing: “High repetition tasks or jobs that require long periods
faces – Ergonomics, Input devices and strategies.                                 of static posture may require several, short rest breaks (mi-
                                                                                  cro breaks or rest pauses). During these breaks users should
INTRODUCTION                                                                      be encouraged to stand, stretch, and move around. This
Repetitive strain injury (RSI) is a general term used to de-                      provides rest and allows the muscles enough time to recov-
scribe soft tissue damage as a result of sustained repetitive                     er.” We believe that as ergonomic injury becomes a more
work, classified by the medical community as a muscu-                             acknowledged and more universal problem, incorporating
loskeletal disorder. In 2001, the National Academy of                             ergonomics-related features into software environments
Science issued a report [16] stating that “Musculoskeletal                        will be critical as both a solution to a major health problem
disorders of the low back and upper extremities are an im-                        and a marketing feature in all computer software.
portant national health problem, resulting in approximately
1 million people losing time from work each year. Conserv-                        Software packages are now available, and are in some cases
ative cost estimates vary, but a reasonable figure is about                       being distributed by employers, that remind computer users
$50 billion annually in work-related costs.” Causes of RSI                        to take periodic breaks. Some popular examples include
range from cooking to driving to keyboard and mouse use;                          WorkRave1, XWrits2, Stretch Break3, and RSIGuard4.
                                                                                  These products remind a user to take short breaks and
Permission to make digital or hard copies of all or part of this work for
                                                                                  stretch his hands at regular intervals.
personal or classroom use is granted without fee provided that copies are
not made or distributed for profit or commercial advantage and that copies        1
bear this notice and the full citation on the first page. To copy otherwise, or
                                                                                    WorkRave, http://www.workrave.org/
                                                                                  2
republish, to post on servers or to redistribute to lists, requires prior           XWrits, http://www.lcdf.org/xwrits/
                                                                                  3
specific permission and/or a fee.                                                   Stretch Break, Para Technologies, http://paratec.com/
                                                                                  4
CHI 2008, April 5–10, 2008, Florence, Italy.                                        RSIGuard, Remedy Interactive, Inc., http://rsiguard.com/
Copyright 2008 ACM 978-1-60558-011-1/08/04…$5.00.




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CHI 2008 Proceedings · Personal Health                                                  April 5-10, 2008 · Florence, Italy

The ergonomic benefits of taking periodic breaks are both        breaks. We then present the results of our field study, and
powerful and well-documented [1,2,9,14,15,16,18,19], but         we conclude with a discussion of future work
since this type of software tends to interrupt workflow, us-
                                                                 RELATED WORK
ers frequently ignore their break reminders or turn off this     While many researchers have documented the benefits of
software shortly after installing it. Furthermore, though        taking breaks, two studies [9] and [15] looked specifically
breaks do have significant preventative value, a user who is     at using software, Stretch Break3, as a means of improving
not already experiencing symptoms of RSI is unlikely to          rest break completion, while Hedge and Evans [8] ex-
even install such software. Various studies have shown that      amined how a program called ErgoManager improved vo-
despite the common perception of breaks reducing produc-         luntary break-taking within two companies. These studies
tivity, frequent short breaks actually increase productivity     examined how typing break reminders could be effective in
and reduce error rates [2]. Balci and Aghazadeh [1] found        encouraging break-taking but did not examine the impact of
that short breaks significantly increased the speed and accu-    break content, which is our focus.
racy of both data entry tasks and mental tasks, and Hedge
and Evans [8] found a 59% improvement in accuracy across         Some previous work in using sensors and interactions to
several job classes. McLean et al. [14] and Saltzman [20]        improve ergonomics focuses on postural problems: Dunne
found that productivity, while not significantly improved, at    et al. [6] describe a postural sensor suitable for biofeedback
least trended higher when study participants took short          applications, and Breazeal et al. [3] present an actuated
breaks throughout the work day. Out of 10 studies sur-           monitor that can unobtrusively manipulate a user’s posture.
veyed, no study reported a reduction in productivity despite     However, we know of no other computer systems that use
the addition of breaks to the work schedule [2,8].               interactions to motivate good ergonomic habits. In the re-
                                                                 lated area of motivating exercise and overall activity, Con-
Given the compelling evidence of the benefits of breaks          solvo et al. [5] and Lin et al. [12] used personal awareness
while working with a computer, it would be natural to as-        and social pressures to increase daily walking habits, while
sume that a majority of users take breaks regularly through-     Lo et al. [13] used game play to encourage better eating
out the day. However, various studies have found that even       habits. This area is becoming known as persuasive compu-
when participants are specifically instructed to take breaks,    ting [7]. Similarly, Bianchi-Berthouze et al. [3] show that
voluntary completion of scheduled breaks ranges from 45-         body movement can improve players’ engagement in com-
55% [9,15,20]. In some cases, participants were removed          puter games and can improve players’ affective experience.
from the study group due to never completing a single rec-
ommended break [2,9].                                            SUPERBREAK

In this paper we present SuperBreak, a software package          Software Architecture
that builds upon the traditional “break-reminder” theme.         SuperBreak’s core functionality is similar to that of existing
SuperBreak seeks to increase break completion by offering        break-reminder packages: the user configures typing break
interactions during breaks that make the breaks less annoy-      durations and inter-break intervals and is informed that a
ing and more productive. SuperBreak leverages a video            break is pending shortly before it is scheduled to begin. We
camera as an alternative input system for use during breaks      adopt the terminology of existing software packages, call-
and offers a variety of in-break interactions, including read-   ing shorter, more frequent breaks “micro-breaks”, and
ing documents, playing a game, and watching videos.              longer, less-frequent breaks “rest breaks”. A typical confi-
                                                                 guration might schedule a 20-second micro-break every 5
We evaluated SuperBreak in a two-week field study with           minutes, and a 5-minute rest break every hour (this is by no
26 information workers. Each person used SuperBreak with         means universal; optimal scheduling will depend on a par-
interactive breaks for one week, and a control version of the    ticular user’s health needs). We focus primarily on micro-
software, in which breaks were not interactive, for one          breaks in this paper, since we expect most users to either
week. All 26 participants, even the 13 who had not pre-          leave their desks or do non-computer-based work during
viously tried break-reminder software, indicated that they       their rest breaks. Between breaks, SuperBreak monitors
planned to continue using break-reminder software after the      keyboard and mouse activity so that naturally occurring
study. Twenty-two participants (85%) preferred SuperBreak        breaks are taken into account. In other words, if a 30-
with interactive breaks to the control version, and on aver-     second micro-break is scheduled to occur every 5 minutes,
age participants took a higher percentage of the breaks of-      it will only be suggested if there is activity at the keyboard
fered in the interactive condition, while typing through         or mouse for 5 minutes without any pauses longer than 30
more of the breaks suggested in the control condition.           seconds.
These data suggest that interactivity can improve the adop-
tion and retention of typing-break-reminder software.            Where SuperBreak differs from typical break-reminder
                                                                 packages is its support for “Activities” during breaks. An
In the remainder of this paper, we first discuss previous        “Activity” is a software module intended to run for the du-
work directly related to break-reminder software. We then        ration of a break, with no keyboard or mouse input. When
describe the SuperBreak package, including a description of      SuperBreak determines that a break is pending, it selects an
the specific interactions currently available to users during    Activity according to the user’s pre-configured preferences



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CHI 2008 Proceedings · Personal Health                                                    April 5-10, 2008 · Florence, Italy

and prepares the appropriate resources needed for that Ac-       With this in mind, SuperBreak includes an activity that uses
tivity (e.g. Web content, a video camera) so they are ready      a vision-based game to encourage stretching (Figure 1).
when the break begins. SuperBreak allows the user to con-
                                                                 The game break uses a standard webcam mounted above
figure the Activity-selection mechanism according to his or
                                                                 the user’s monitor to capture a video image of the user at
her preferences. For example, a user might configure Su-
                                                                 her desk. As shown in Figure 1, the user sees the image
perBreak to offer a preferred Activity 80% of the time, with
                                                                 with one, two, or three on-screen targets superimposed (the
an alternative Activity 20% of the time.
                                                                 red and green quarter-circles in Figure 1). To score points,
To start a break, SuperBreak provides display resources to       the user moves his or her hands up to touch the target(s) and
the selected Activity and optionally locks out the keyboard      then down off the target(s). When motion is detected within
and mouse. Additional notifications are provided to the          the target(s) before a short time window elapses, the system
current Activity shortly before a break is scheduled to end      plays a ‘success’ sound and the user scores points for each
and at the end of a break, allowing resources to be de-          target hit. Points are deducted if the user fails to activate the
allocated and any necessary notifications provided to the        target(s) or activates incorrect targets. New targets are then
user. After the break is finished, SuperBreak returns the        displayed in a different location. The targets are purposely
user’s desktop to its pre-break state. The goal of these re-     placed such that the user is encouraged to reach above his
source management procedures is to ensure that Activities        head; this motion rotates the shoulders and encourages
are available immediately when a break begins, and that the      blood flow to the player’s hands and wrists.
user’s desktop state is restored seamlessly when a break
                                                                 Target activation is detected using simple frame-to-frame
ends.
                                                                 subtraction. A change image is created for an incoming
SuperBreak is implemented in C++ and C#, and runs on             camera frame by subtracting the intensity at each pixel from
Microsoft Windows operating systems.                             that observed in the previous frame. A threshold is applied
                                                                 to determine the set of active pixels; if a target area contains
ACTIVITIES
Activities are intended to encourage the user both to com-       a sufficient number active pixels for a threshold period of
plete the suggested break and to maintain a healthy ergo-        time, it is considered “hit”, and the user is rewarded or pe-
nomic posture and activity level during the break. Although      nalized depending on the set of targets currently displayed
we could imagine a wide variety of options for Activities,       and the set of targets currently activated by hand move-
we selected four for the study. Two of the Activities – a        ment. Throughout our field study, we found this simple
gesture-based document-reading system and a gesture-             approach to be remarkably robust to varying lighting condi-
based game – are active in nature and the user is encour-        tions, office configurations, and camera orientations. Image
aged to physically move his or her body or arms during the       processing is performed using the OpenCV library [17].
break in order to interact with SuperBreak. Both make use        Activity 2: Vision-Based Document Reading
of computer vision techniques and a video camera to allow        We also wanted to experiment with activities that allow the
keyboard-free, mouse-free interaction.                           user to continue working during breaks without using the
                                                                 keyboard and mouse. One productivity task that is particu-
The other two Activities are passive in nature, as they do
                                                                 larly well-suited to typing breaks is document reading,
not require the user to physically do anything during the
                                                                 which primarily requires passive viewing and periodic ver-
break. The first passive Activity allows the user to view
                                                                 tical scrolling. To allow users to defer document-reading
online videos. The second passive Activity is the “standard
break”, which simply places a text reminder to take a break
on the screen. The standard break was designed as a control
condition for our experiment, and is consistent with the
reminders provided by traditional break-reminder packages.
We purposely selected both active and passive Activities, as
well as Activities that are either entertaining (game, videos)
or productivity-oriented (document-reading), to explore the
space of possible Activity types.
The following subsections describe these activities in more
detail.
Activity 1: Vision-Based Game
A significant shortcoming of existing break-reminder soft-
ware is that it is difficult to enforce or encourage active
stretching during ergonomic breaks; many users – eager to
continue with their work – will fail to move around during a
short break and will maintain the same tense posture they
employ while typing, minimizing the break’s effectiveness.
                                                                      Figure 1: SuperBreak’s Vision-Based Game Activity.



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CHI 2008 Proceedings · Personal Health                                                       April 5-10, 2008 · Florence, Italy




(a)
(




                                                                         Fig
                                                                           gure 3: SuperBr
                                                                                         reak’s Passive V
                                                                                                        Video-Viewing A
                                                                                                                      Activity.

                                                                           encing is susce
                                                                     differe             eptible, such as large-scale b
                                                                                                        s             background
                                                                     movem ment, changes i lighting, etc.
                                                                                         in
      (b)
                                                                     Since bbreaks are ofte too short fo a user to re a com-
                                                                                           en           or            ead
                                                                     plete ddocument, the currently-sele
                                                                                                       ected documen and the
                                                                                                                      nt
                                                                     scroll p
                                                                            position within that documen persist across breaks.
                                                                                          n            nt             s
                                                                     Activity 3: Passive Vid Presentati
                                                                            y              deo        ion
                                                                     The passive video presentation A     Activity proviides either
Figure 2: Sup
F               perBreak’s Vision-Based Do   ocument-Readin  ng      informmative or enter rtaining conten that require minimal
                                                                                                         nt            es
Activity. Within the Activity window (a), the user is presented
A               n             w                                      user innitiative, but s
                                                                                           still encourage break-taking This ac-
                                                                                                         es            g.
with a list of av
w               vailable docum
                             ments, a docume ent-viewing areea,      tivity l
                                                                            leverages the growing popu   ularity of the Web as a
and a gesture-based navigati
a                             ion area. The navigation are  ea,      source of video cont  tent to provide a familiar form of pas-
                                                                                                         e
expanded at th bottom of this figure, pr
e               he                           rovides feedback        sive in
                                                                           nteraction.
about the loca
a               ations mapped to each avai   ilable navigatioon
command.
c                                                                    SuperB Break’s implem  mentation of this activity (Figure 3)
 asks to their e
ta             ergonomic brea aks, we have d developed a SSu-        allows the user to ch hoose a set of “
                                                                                                          “video sources that will
                                                                                                                         s”
perBreak Activ that allow vision-based reading of an
p              vity         ws              d              nd        be poll daily for a list of availab videos. Ex
                                                                             led                          ble           xamples in-
selecting amon documents (Figure 2). An associated Web
s              ng            (             n                         clude youtube.com and crackle.com, with the ability to
                                                                                                                        e
browser plugin allows the us to queue do
b              n             ser            ocuments durin ng        select among specifi categories a each source, limited in
                                                                                           ic            at
normal Web br
n               rowser use for later reading, using an exte
                             r                            en-        our st tudy to sources known to be filtered f office-
                                                                                                                         for
sion to the brow
s              wser’s context menu.                                  approp priate content. Since longer videos tend to contain
                                                                     little co
                                                                             ontent in the f
                                                                                           first few second a typical m
                                                                                                          ds,           micro-break
During a docum
D              ment-reading break, a video c
                               b              camera is used to      would complete befo meaningful regions of a long video
                                                                                           ore            l
detect simple h
d               hand gestures that allow the user to switch
                                               e                     could b presented to the user. The
                                                                             be             o             erefore, videos are sorted
                                                                                                                        s
among docume
a               ents, scroll within documen and remov
                                              nts,             ve    by dura ation and are o
                                                                                           optimally match to break le
                                                                                                          hed           engths.
documents from the current reading list. Th
d              m                r              hese actions coor-
respond to activ
r                vation of the icons shown in Figure 2b: ac
                                              n              cti-    Activity 4: Standard B
                                                                            y             Break
vation of the v
v              vertical green arrows scrolls the current do
                               a                             oc-     For coompleteness, w mention the “standard br
                                                                                           we             e             reak” here;
ument, activati of the hor
u               ion            rizontal black arrows switch  hes     during a “standard br  reak” the user receives a sim
                                                                                                                        mple notifi-
among docume
a              ents, and activa ation of the “X icon remov
                                              X”             ves     cation window that shows the tim remaining during the
                                                                                                         me
th current document from the reading li Once agai
 he                                            ist.           in,    break ((Figure 4). Thi break type is used as a con
                                                                                           is             s             ntrol condi-
th
 hese gestures were chosen to encourage t user to rai
                                t              the            ise    tion in the field study described bel
                                                                                           y              low.
his
h hands abov his head dur
               ve              ring the break, and can also b  be    Notifica
                                                                            ations and Use Interface
                                                                                         er
easily classifie in real-time using the si
e              ed              e              imple compute   er-    We br riefly discuss t types of n
                                                                                          the          notifications p
                                                                                                                     provided to
vision techniqu discussed in the “game break” sectio
v               ues                           e               on     users b SuperBreak and the brea
                                                                           by            k             ak-management actions a
above. In addi
a               ition to the te echniques use for the gam
                                              ed             me      user ca perform, as they are releva to our field study.
                                                                           an                          ant
break to recogn target activ
b              nize             vation, gesture classification is
                                              e
further simplif
f              fied for the do  ocument-readin break by r
                                               ng             re-    Twelve seconds befo each suggested break, the user rece-
                                                                            e             ore                         e
quiring that on a single ico be activated for a thresho
q              nly             on             d              old     ives an auditory not
                                                                            n             tification and a visual remin
                                                                                                                      nder in the
period of time b
p               before navigati commands are issued. Th
                                ion           s               his    lower-rright corner of his primary m
                                                                                          f             monitor (Figure 5a). This
tends to filter out most sour  rces of noise t which fram
                                               to            me-     notification contains a “skip” butto that allows the user to
                                                                                                        on



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CHI 2008 Proceedings · Personal Health                                                  April 5-10, 2008 · Florence, Italy


                                                                (a)


                                                                (b)
         Figure 4: SuperBreak’s “standard break”.
prevent a break from starting (this button resets Super-        Figure 5: SuperBreak’s Pre-Break Notification Window. (a)
Break’s micro-break timer and skips the break entirely) and     The pre-break notification presented when interactive breaks
a “postpone” button that defers the proposed break for two      are available. (b) The pre-break notification presented in our
minutes. During our field study, a default Activity was se-     field study’s control condition, in which only standard breaks
lected at random (game, video, or document); however, in        are available.
general, the user can specify preferences for how often dif-    most 10 minutes of sustained input activity. The keyboard
ferent types of Activities should be selected. The pre-break    and mouse were not locked during breaks by default.
notification window also includes a drop-down box that          To evaluate SuperBreak, we used a within-subjects design
allows the user to change the Activity that will be used dur-   in which participants used SuperBreak on their office PCs
ing the upcoming break. During the control condition of the     in “interactive mode” for 5 work days and “standard mode”
field study this drop-down box was disabled, allowing par-      for 5 work days. In interactive mode, SuperBreak randomly
ticipants to take only the “standard” break; this simplified    selected among the three novel break types (video, game,
pre-break notification window is shown in Figure 5b.            document) for each micro-break. In standard mode, Super-
All four Activity windows (Figures 1-4) also provide a          Break was configured to be similar to existing break-
“skip” button that allows the user to skip a break that has     reminder software, so every micro-break was a “standard
already started.                                                break”. Note that the difference in conditions applies only
                                                                to micro-breaks; micro-breaks were the primary target of
FIELD STUDY
                                                                our investigation and the primary consideration when de-
To evaluate the use of SuperBreak and the benefits of inter-    signing our Activities, as they are the focus of the relevant
active breaks, we recruited 26 participants (12 male) within    ergonomics literature. All rest breaks in both conditions
our organization5. We selected both participants that either
                                                                were configured by default to be “standard” breaks, and
currently used or had previously tried break-reminder soft-     participants were encouraged to use rest breaks to leave
ware (6 men and 7 women) and participants that had never
                                                                their desks or do non-computer work. Participants were
tried break-reminder software (6 men and 7 women). Each
                                                                provided with a USB web camera for the period during
participant used SuperBreak for 10 working days (typically      which they were using SuperBreak in “interactive mode”,
two calendar weeks, but occasionally longer to account for
                                                                as a video camera is required for two of the three Activities.
vacation days).                                                 The order in which participants experienced standard or
We configured SuperBreak to suggest a 25-second micro-          interactive mode was counter-balanced across participants.
break after every 8 minutes of interaction. This meant that a   All participants completed the study with at least 5 work
micro-break was suggested every time a participant typed        days in each condition except for two: one participant had
or used the mouse for 8 minutes without a 25-second period      only 3 work days in the standard condition due to a job
of inactivity. A 25-second period of inactivity would reset     change during the study, and another had only 4 days in the
SuperBreak’s internal countdown to the next micro-break.        interactive condition due to unexpected travel.
Therefore, how frequently breaks were offered depended on       Participants in the study filled out a pre-study survey, a
each participant’s typing habits. These defaults were chosen
                                                                mid-point survey (when they switched conditions), and a
based on a pilot study to ensure breaks were proposed fre-      post-study survey (after using both versions of Super-
quently enough to support the study, but did not overly in-     Break). We visited all participants at the beginning of the
terfere with participant productivity. Research by Slijper et
                                                                study to install SuperBreak, at the mid-point to switch con-
al. [21] found the number of naturally occurring typing         ditions, and at the end to collect logging data from Super-
breaks follows a power law, such that increases in sug-         Break. During the study period, SuperBreak logged usage
gested break length decrease the number that naturally oc-
                                                                information including the breaks suggested and whether
cur, supporting our choice of relatively short micro-breaks.    each break was taken or skipped. To account for variations
Participants could adjust the length and frequency of breaks    in usage time and number of breaks offered across our par-
if desired, to maintain consistency with any previous use of
                                                                ticipants, all log data is analyzed as percentages of each
break-reminder software, although we required micro-            user’s suggested breaks in each condition. At the end of the
breaks to be at least 20 seconds long and to occur after at
                                                                study, participants received a gratuity for their participation
                                                                valued at approximately $20.
5
 We began the study with 28 participants, but one partici-      Demographics
pant was unable to complete the study due to hardware           Our 26 participants were all between the ages of 20 and 55.
problems and another had to travel unexpectedly.                All participants worked at our organization, but the study




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CHI 2008 Proceedings · Personal Health                                                  April 5-10, 2008 · Florence, Italy

pool spanned a range of occupations, including researchers,      we note that this software uses a strict timing mechanism so
software developers, and marketing specialists. Our selec-       this interval cannot be directly compared with the input-
tion criteria aimed to balance male and female participants,     based timing used by SuperBreak.
and participants who had previously tried break-reminder
                                                                 Results: Questionnaire Data
software with participants who had not. Our only additional      On the post-study survey we asked participants explicitly
selection criterion was that participants work at a single PC    which version of SuperBreak (interactive or standard) they
during the work day, on which we installed SuperBreak.           preferred. The interactive condition was preferred by 85%
Each participant reported spending at least 6-10 hours per       (22 of 26) of participants. We were also particularly pleased
work day at a computer, and 8 reported spending more than        that all participants, even those that had not previously used
10 hours per day at a computer. Our participants were long-      break-reminder software, reported they would continue
time computer users; 11 participants had been using a com-       using break-reminder software. Eighteen wanted to use
puter more than 20 hours per week for 6-10 years, and the        interactive SuperBreak, four wanted the standard version,
remaining 15 participants for more than 11 years.                and four planned to use other break-reminder software.
                                                                 Eighteen of our participants retained the SuperBreak appli-
We collected data on participants’ self-reported experience      cation on their computers at the conclusion of the study
and concerns with RSI, to inform interpretation of our re-       when the researchers offered to uninstall it as part of our
sults. In our pre-study survey, participants were asked to       final office visit.
report their levels of concern about RSI and other related
health problems on a four point scale from ‘Not concerned’       When asked why they preferred the interactive version,
(1) to ‘Very concerned’ (4). Not surprisingly, given that        responses by 11 participants highlighted that the breaks
they volunteered for our field study, the median response        were more interesting and engaging. Representative com-
was ‘concerned’ (3). All participants reported experiencing      ments included “love the game, love video. I hate sitting
some pain or discomfort they believed was related to com-        and just watching a clock tick” (P10), “More fun. Motiva-
puter use. Seven participants reported experiencing pain         tion to take a break” (P13), and “the breaks were more en-
daily, three experienced pain several times per week, four       gaging” (P20). Four participants (P5, P12, P25, P28) com-
experienced pain several times per month, and the remain-        mented on the fact that the encouraged hand movement and
ing 12 reported experiencing pain previously but not on a        stretching. Three participants (P7, P17, P23) also com-
regular basis. Fifteen participants reported they had visited    mented on the variety of Activities, as exemplified by:
a doctor for a health condition related to working on com-       “More variety in the breaks, motivation to take the break
puters. When asked to estimate what percentage of their co-      through game” (P17), and “I like the variety of activities. It
workers had experienced significant discomfort due to            made me want to take the breaks.” (P7).
computer use, only one participant reported not knowing          For the four participants (P4, P16, P19, P27) who preferred
anyone who has been affected by ergonomic problems.              the standard version, two felt the interactive version was too
Most participants (62%, 16/26) reported that between 1%          intrusive. For example, P16 said “The standard version was
and 25% of their co-workers had experienced problems,            not intrusive and worked.” The other two participants each
and the remaining nine participants reported that more than      found two of the interactive break types annoying. P4 dis-
26% of their co-workers had problems.                            liked document-reading and video-viewing, while P19
To address concerns about ergonomics, several participants       stated “I found that the game/document breaks in the [inter-
were currently using non-standard computer peripherals           active] version a little annoying and preferred simple breaks
such as ergonomic keyboards (12 participants), ergonomic         for the short micro breaks.”
chairs (7 participants), and ergonomic mice (6 participants).    Results: Log Analysis
Participants had also made adjustments to their work prac-       To evaluate participants’ use of SuperBreak in more depth,
tices including incorporating stretching exercises (15 partic-   we compared the percentage of breaks taken in each condi-
ipants) and alternating or permanently changing the hand         tion based on the log files produced by SuperBreak.
they use for holding the mouse (9 participants). Six partici-
pants had consulted a professional ergonomist to assist in       During the study, all participants were offered at least 20
the configuration of their offices.                              micro-breaks in each condition and the average across par-
                                                                 ticipants was 81 micro-breaks offered in the interactive
We asked the 13 participants who had experience with             condition and 90 in the standard condition (not a significant
break-reminder software some additional questions. Of            difference according to a paired t-test). While participants’
these participants, 7 were currently using the break-            working style and typing habits impact the number of
reminder software provided by our organization and most          breaks offered, we feel comfortable that all participants
(6 of 7) reported running the software 75-100% of their          experienced enough breaks during the study to give us in-
work day. When asked how satisfied they were with the            formed feedback. We also stress that breaks were only sug-
software, the median response was ‘neutral’ on a five-point      gested after periods of sustained keyboard or mouse activi-
Likert scale. All 7 had the software configured so that more     ty, so all of these micro-breaks were suggested when partic-
than 15 minutes elapsed between micro-breaks, although           ipants were physically present at their computers.



                                                             1822
CHI 2008 Proceedings · Personal Health                                                    April 5-10, 2008 · Florence, Italy

                                                                   Results: Interactive Break Types
                                  Interactive      Standard
                                                                   In addition to estimating the overall value of interactive
    % of breaks taken                65.5             49.9         breaks, we assessed the relative effectiveness and subjective
                                                                   perception of each of SuperBreak’s Activities, to inform the
    % of breaks typed through         3.5             11.4
                                                                   design of future interactive break-reminder programs. We
Table 1: Summary of the key differences between the interac-       asked participants Likert-scale questions about whether
tive and standard conditions; both differences are significant.    they liked each of the Activities, and to rank the Activities
                                                                   in order of preference.
Given that breaks offered are an interruption and that pre-
vious studies have found that voluntary completion of sche-        Game Breaks
duled breaks ranges from 45-55% [9,15,20], we expected             Overall, the game break was most preferred by our partici-
participants would skip a considerable percentage of their         pants. Fourteen participants (54%) ranked the game break
breaks. We calculated the percentage of breaks taken by            first, and the median response when asked to respond to the
participants in each condition by dividing the number of           statement ‘I liked taking Game Breaks’ was ‘Agree’ (4) on
“taken” breaks by the total number of suggested breaks. A          a five-point Likert scale from “Strongly Disagree” to
suggested break is counted as “taken” if the participant did       “Strongly Agree.” Positive comments about game breaks
not explicitly skip it (i.e. does not press the “skip” or “post-   included “I prefer to move and stretch during breaks so I
pone” buttons) and did not continue typing through the             liked the game breaks the best” (P24) and “game breaks are
break (recall that we did not disable input devices during         great and don't really interrupt my work flow” (P10). How-
breaks)6. We hypothesized that the percentage of breaks            ever, not everyone liked the game breaks. Four participants
taken would be higher when participants were using the             (P9, P14, P19, P23) made comments about being worried
interactive version of SuperBreak.                                 about looking silly or unprofessional while playing the
                                                                   game. For example, P19 stated “I felt I looked strange play-
On average, participants took 65.5% of the interactive             ing the game breaks – my office is in a location where I am
breaks offered compared to only 49.9% of breaks offered in         visible to passers-by.”
the standard condition (Table 1). A paired-samples t-test
shows that these percentages are significantly different           Video-Viewing Breaks
(p=0.005). Post-study survey responses are consistent with         Seven participants (27%) ranked the video-viewing Activity
the logging data. On the post-study survey, when asked             as their favorite break type. Supporting comments included
whether they were more likely to skip breaks in the interac-       “I enjoyed the video because it was a few moments of en-
tive condition or the standard condition, most participants        tertainment. If I'm going to break away from work, that
(69%, 18/26) reported that they thought they were more             gave the best mental break” (P14) and “The videos were
likely to skip breaks when using the standard condition,           entertaining and they took my mind away from work to
while 5 participants reported that the version had no effect       relax for a bit.” (P1). Ten participants commented that they
and 3 felt they were more likely to skip breaks in the inter-      found it frustrating that interesting videos ended abruptly at
active version. Similarly, at the end of each condition we         the end of breaks. This highlights an interesting design
asked participants what fraction of micro-breaks they be-          choice for Activity-based breaks: users were engaged in the
lieved themselves to have skipped in that condition. Fol-          video content, but an ideal experience within a break may
lowing the interactive condition, participants felt they           sometimes come at the cost of extending breaks and thus
skipped between 25%-49% (median response on a four-                risking additional interruption. Some participants’ comput-
point scale) while the median for the standard condition           ers also had issues caching video appropriately before each
was 50 – 74%. These medians are significantly different            break so that it started immediately, also highlighting an
based on the Wilcoxon test with z=-2.546, p = .011.                important point for software implementation of Activity-
                                                                   based breaks: for such a short interactive experience, ap-
In addition to taking a smaller percentage of breaks offered       propriate preparation of resources before breaks is critical.
in the standard condition, participants were also significant-
ly more likely to continue typing through breaks – without         Document-Reading Breaks
explicitly canceling them – in the standard condition than         Five participants (19%) rated document-reading breaks as
the interactive condition. On average, participants typed          their favorite. Positive comments focused on the ability to
through 11.4% of breaks offered in the standard condition          use breaks constructively, for example “the doc reading was
and only 3.5% of those in the interactive condition                educational, so I felt it was a good use of my time.” (P8)
(p=0.001).                                                         and “Document reading is both interactive and potentially a
                                                                   useful way to pass the break, which is why I ranked it first.”
                                                                   (P6). Eight participants commented about challenges using
6
                                                                   the hand gesture navigation, in particular accidently delet-
  Breaks in which fewer than 5 keystrokes and fewer than 5         ing documents, which we can address through further re-
mouse-click events occurred were considered “taken”; this          finement of our gesture set and image-processing tech-
allows for cases where a participant took a brief period of        niques. However, four participants found it difficult to
time to stop typing in response to the initiation of a break.      switch contexts quickly enough to read documents during a



                                                               1823
CHI 2008 Proceedings · Personal Health                                                     April 5-10, 2008 · Florence, Italy

   Activity                  Percentage of breaks taken            We present all statistics for rest breaks using data from both
                                                                   conditions in the study, as there was no difference in the
   Game                             69.6% (28.0)                   behavior of rest breaks in the two conditions7. Participants
   Video-viewing                    62.6% (29.1)                   received, on average, 32.5 suggested rest breaks (SD 19.8,
                                                                   min 0, max 69) throughout the course of the study. On av-
   Document-reading                 63.4% (32.3)                   erage, participants took 25.3% of suggested rest breaks (us-
Table 2: Percentage of breaks taken when each Activity was
                                                                   ing the same definition for a “taken” break that we describe
suggested, averaged across participants. Parentheses indicate      above for micro-breaks). This number is actually somewhat
standard deviations.                                               higher than we would have expected, since rest breaks
                                                                   represent a relatively long interruption.
micro-break. P10 states: “Document breaks were hard –
shifting gears to ingest information from reading material         Breaks as Workflow Interruptions
and then going back to my work was time consuming and              Although we have demonstrated that interactivity during
frustrating.” This again highlights the unusual nature of          breaks did encourage increased break-taking, a major con-
interaction and content design for Activity-based breaks;          cern for the design of break-reminder software is the
minimizing the cognitive overhead of engaging with break           workflow disruption created by breaks or even by break
content will leave more time for meaningful interaction            suggestions. We do not address this in detail, but point
during breaks.                                                     briefly to questionnaire results indicating that despite par-
                                                                   ticipants’ desire to continue using break-reminder software,
Impact of Activity type on break-taking                            the median response to the statement “I found this version
Table 2 shows the percentages of breaks taken when each            of SuperBreak annoying” was ‘Agree’ (4) in the standard
Activity was suggested to the user; these numbers are              condition and ‘Neutral’ (3) in the interactive condition
drawn only from the “interactive mode” data, since Activi-         (these medians are not significantly different). Quotes from
ties are not used in “standard mode”. The game break re-           participants support the notion that break reminders are a
sulted in the highest percentage of breaks taken, which is         significant workflow interruption. P5 states: “…if I'm typ-
consistent with the subjective questionnaire data discussed        ing a bunch (and rapidly), I probably don't want to be inter-
above, but differences among these percentages are not             rupted, and providing me an opportunity to postpone
significant after correction for multiple comparisons.             doesn't work, because that still breaks my train of thought.”
In reviewing participants’ comments, we were struck by the         Previous experience with break-reminder software
divergence in preferences among participants. Furthermore,         We recruited participants so as to balance individuals who
numerous comments highlighted the inherent advantage of            had never used break-reminder software with those who
variety in keeping users’ attention, for example: “variety is      had tried break-reminder software in the past or were cur-
very important for something one interacts with so fre-            rently using break-reminder software. We expected that
quently” (P11). Coupled with the fact that no Activity re-         participants in the latter category, who had been sufficiently
sults in an overwhelmingly higher percentage of breaks             motivated at some point to install traditional break-
taken, this suggests that future design of Activity-based          reminder software, might be more receptive to SuperBreak,
breaks should continue to include a variety of potential Ac-       i.e. that they would take more breaks and would provide
tivities.                                                          subjectively more positive responses in both conditions.
Rest Breaks                                                        Interestingly, we found no effect of previous experience
We focus primarily on micro-breaks (short, frequent                with break-reminder software on either break-taking proba-
breaks) in this evaluation, as the ergonomics literature has       bility (in either condition or across conditions) or subjective
primarily identified short, frequent breaks as an appropriate      response. It may be the case that our expectation of a signif-
strategy for reducing the risk of RSI and we have corres-          icant effect of previous experience with break-reminder
pondingly designed SuperBreak’s Activities under the as-           software was unfounded. However, we also note that we
sumption that they would be used for short durations. Par-         did not directly compare SuperBreak to other break-
ticipants in our study were encouraged to use suggested rest       reminder packages that participants had used in the past,
breaks (longer, less-frequent breaks) to leave their desks or      and are thus unable to explore whether even the standard
do non-computer work. However, we briefly discuss here             condition of SuperBreak was sufficiently different from
the data we gathered regarding participants’ habits with           other packages, in its scheduling mechanism, UI, system
respect to rest breaks.                                            integration, etc., to negate effects of previous experience.
During our study, SuperBreak was configured to suggest
five-minute rest breaks every hour, using the same schedul-
ing policy used for micro-breaks; i.e., a break was only           7
                                                                    We performed all of the same analyses for comparing rest-
suggested if a participant typed for one hour without a five-      break-taking across conditions that we describe above for
minute gap in activity. SuperBreak presented the “standard         micro-breaks, and, as expected, found no significant differ-
break” (Figure 4) during rest breaks                               ences across conditions.




                                                                1824
CHI 2008 Proceedings · Personal Health                                                  April 5-10, 2008 · Florence, Italy

DISCUSSION                                                       Diversity of Activities is important
We now highlight several important themes that emerged           While we anticipated that different participants might prefer
from our experience designing and studying SuperBreak.           different breaks types, we expected that participants might
                                                                 also appreciate variety in SuperBreak’s Activities. Some
Interactive micro-breaks were successful
At the inception of this project, we realized that the length    participants did appreciate variety, however the strength of
of a typical micro-break is rather short and we worried          preference other participants expressed to us for particular
about whether interactivity during that time would be feasi-     break types (e.g. only game or only document) was some-
ble. That most of our participants preferred the interactive     what surprising. For example, P4 states: “if it didn't have
condition shows that short activities were possible, and de-     the document-reading and video-playing, which were an-
sirable, even in 25 seconds. However, in cases where breaks      noying, if the interactive version had just been the game-
did not start smoothly due to inadequate pre-fetching of         playing, with a variety of games, it would have been bet-
content, participants expressed significant displeasure. P27     ter.” This highlights the importance of providing a variety
states: “The video was my least favorite because it took so      of break types to accommodate diverse users. Similarly,
long for the video to load that the break was half over be-      while we deliberately designed break content that encou-
fore it started.” This emphasizes the importance of having       rages physical movement, participants’ levels of comfort
all necessary resources (e.g. videos, documents) cached          doing physical activities varied based on their office envi-
before each break so that the break can start seamlessly         ronments.
with no waiting by the user. We will continue to improve         We also note that all of the interactions we have described
the pre-break caching of content in SuperBreak; a particular     are individual activities, but collaborative or social breaks,
design and implementation challenge here is preparing con-       such as brief video conferences or collaborative games,
tent without introducing computer load that disrupts the         might also appeal to many potential users. For example,
user even before a break is formally suggested.                  referring to game breaks, P1 states: “just beating my own
One thing that did surprise us was the extent to which par-      high score is not as fun as perhaps playing against or chal-
ticipants wanted to continue engaging in video-viewing and       lenging someone else's score.” We are interested in explor-
document-reading micro-breaks beyond the duration of a           ing the feasibility and social dynamics associated with simi-
break. Despite the workflow interruption, participants ra-       larly brief collaborative activities in future work.
pidly became engaged in break content and in many cases          Scheduling of breaks could be ‘smarter’
desired that content to come to a natural conclusion. This       This study focused on participants’ experiences during the
highlights another important challenge for the design of         breaks provided by SuperBreak, rather than on the schedul-
interactive breaks: break activities should be self-contained    ing of those breaks. SuperBreak schedules breaks based on
and end at natural boundaries, but breaks that are too en-       keyboard and mouse activity, rather than on timed intervals
gaging can potentially result in decreased productivity.         alone, but does not otherwise optimize the scheduling of
                                                                 breaks so as to minimize annoyance or disruption. In both
We note that the “game” and “document-reading” breaks
                                                                 conditions, field study participants felt the software pro-
made use of interactions that users had not previously expe-
                                                                 posed breaks at inconvenient times. The median response
rienced, and the extent to which the success of interactive
                                                                 was ‘Agree’ (4) in both conditions when participants were
breaks depended on novelty cannot be assessed by the
                                                                 asked to respond to the statement “This version scheduled
present study. We defer a longitudinal evaluation of Super-
                                                                 breaks at inconvenient times.” P25 states: “I hated the mi-
Break – which would rule out this effect – to future work.
                                                                 cro breaks. They almost always popped up at inconvenient
However, we saw no statistical evidence of a decrease in
                                                                 times, and broke my concentration when I was trying to
breaks taken over time throughout the study period (al-
                                                                 focus.” P22 commented “Rest breaks often appeared right
though we acknowledge that this is not equivalent to a sta-
                                                                 before I was going to take a long break anyway (e.g., lunch
tistical demonstration that such a decrease does not exist).
                                                                 or a meeting), and these I was particularly likely to ignore.”
The comparison of interactive and non-interactive breaks is
                                                                 We defer to future work the integration of more sophisti-
also affected by a difference in window size among the
                                                                 cated mechanisms for enhancing the input-activity-based
break types. Our “standard break” is intended to approx-
                                                                 scheduling of breaks used by SuperBreak. For example,
imately represent existing break-reminder software and was
                                                                 digital calendar data is frequently available; this could al-
designed accordingly; the activities presented in our inter-
                                                                 low future break-reminder software to avoid proposing
active breaks necessitate increased screen space to facilitate
                                                                 breaks when the user is about to leave the office (and thus
interactions. In our view, our study shows that participants
                                                                 will implicitly be taking a break) or is conducting an in-
chose not to skip interactive breaks despite the relatively
                                                                 office meeting (and thus is unlikely to welcome an interrup-
high demands on screen space and consequent intrusiveness
                                                                 tion). Similarly, in-office sensors could be used to deter-
on workflow, which strongly supports the notion that inte-
                                                                 mine whether a user is currently engaged in physical activi-
ractivity is a strong motivator for break-taking. However,
                                                                 ty that alleviates the need for a break, or is engaged with
because screen size is an uncontrolled variable, we cannot,
                                                                 co-workers and thus would probably prefer not to be inter-
at present, comprehensively disambiguate all the properties
                                                                 rupted. We also point to related work on using probabilistic
of SuperBreak that render it effective.



                                                             1825
CHI 2008 Proceedings · Personal Health                                                     April 5-10, 2008 · Florence, Italy

models to assess the cost or annoyance associated with in-         5. Consolvo, S., Everitt, K., Smith, I., Landay, J. A. 2006.
terruptions based on computer or sensor state (e.g. [11]);             Design requirements for technologies that encourage
this work presents a natural basis for the “smart” scheduling          physical activity. Proc CHI 2006.
of typing breaks. In incorporating any such mechanisms for         6. Dunne, L.E., Walsh, P., Smyth, B., Caulfield, B. Design
reducing annoyance, there is clearly a balance that will need          and Evaluation of a Wearable Optical Sensor for Moni-
to be struck between determining “good” times to interrupt             toring Seated Spinal Posture. Proc 10th Intl Symp on
a user and making sure that breaks are proposed even when              Wearable Computers, 2006.
no perfect break time occurs, according to the user’s ergo-
                                                                   7. Fogg, B.J. Persuasive Technology: Using Computers to
nomic needs. We highlight that this area is critical for im-
                                                                       Change What We Think and Do, San Francisco, CA:
proving the wider adoption of ergonomic break-taking prac-
                                                                       Morgan Kaufmann Publishers, 2003.
tices through break-reminder software, as users who are not
immediately concerned about RSI may be unlikely to tole-           8. Hedge, A., Evans, S. J. (2001): Ergonomic Management
rate poorly-timed interruptions in the interest of long-term           Software and Work Performance: An Evaluative Study.
ergonomic benefits.                                                    Cornell University Technical Report/RP 2501.
CONCLUSION
                                                                   9. Henning, R.A., Jacques, P., Kissel, G.V., Sullivan, A.B.,
Our study of SuperBreak with 26 knowledge workers high-                Alteras-Webb, S.M.. Frequent short rest breaks from
lights the benefits of interactivity and diverse activities dur-       computer work: effects on productivity and well-being
ing breaks in encouraging people to take micro-breaks from             at two field sites. Ergonomics 40(1) (1997).
typing. As we believe that the need to encourage people to         10. Horvitz, E., Apacible, J., Koch, P. BusyBody: Creating
engage in healthy ergonomic behavior will only increase as             and Fielding Personalized Models of the Cost of Inter-
people spend more time using computer input devices, we                ruption. Proc CSCW 2004.
are excited by the response to SuperBreak and its potential        11. Horvitz, E., Apacible, J. Learning and Reasoning about
to contribute to a potentially high-impact health issue.               Interruption, Proc. ICMI 2003.
Additionally, the design of SuperBreak focuses on minimiz-         12. Lin, J., Mamykina, L., Lindtner, S., Delajoux, G., Strub
ing continuous typing, but there are other ways in which               H.B. Fish’n’Steps: Encouraging Physical Activity with
working at a computer can detrimentally impact a user’s                an Interactive Computer Game. Proc UbiComp 2006.
health. In future work, we will explore mechanisms that            13. Lo, J-L., Lin, T-Y., Chu, H-h., Chou, H-C., Chen, J-h.,
encourage users to adjust posture or engage in gross physi-            Hsu, J., Huang, P. Playful Tray: Adopting Ubicomp and
cal movements, reducing potential spinal problems. Simi-               Persuasive Techniques into Play-Based Occupational
larly, the design of breaks that use non-visual stimuli might          Therapy for Reducing Poor Eating Behavior in Young
leverage the benefits of interactivity demonstrated in this            Children. Proc UbiComp 2007.
paper while encouraging users to look away from the moni-          14. McLean, L., Tingley, M., Scott, R.N., and Rickards, J.
tor during breaks, reducing the potential for eye strain asso-         Computer terminal work and the benefits of micro-
ciated with computer use. In both of these scenarios, using            breaks. Applied Ergonomics 32(3) (2001).
computer vision techniques may allow us to provide closed-
loop feedback about posture or gaze and encourage corres-          15. Monsey, M., Ioffe, I., Beatini, A., Lukey, B., Santiago,
ponding adjustments to ergonomic behavior.                             A., James A.B. Increasing compliance with stretch
                                                                       breaks in computer users through reminder software.
REFERENCES                                                             Work; 2003, Vol. 21.2.
1. Balci, R., Aghazadeh, F. 2004. Effects of exercise
                                                                   16. National Academy of Science. Musculoskeletal Disord-
   breaks on performance, muscular load, and perceived
                                                                       ers and the Workplace: Low Back and Upper Extremi-
   discomfort in data entry and cognitive tasks. Comput.
                                                                       ties. National Academy Press (2001).
   Ind Eng. 46, 3 (Jun. 2004).
                                                                   17. OpenCV: http://intel.com/technology/computing/opencv
2. Barredo, R. Mahon, K. The Effects of Exercise and Rest
   Breaks on Musculoskeletal Discomfort during Computer            18. OSHA Ergonomic Solutions: Computer Workstations
   Tasks: An Evidence Based Perspective, Journal of Phys-              eTool,       Work       Process       and     Recognition:
   ical Therapy Science, Vol. 19, 2007.                                http://osha.gov/SLTC/etools/computerworkstations/wor
                                                                       kprocess.html, viewed 9/12/2007.
3. Bianchi-Berthouze, N. Kim,W., Darshak,P. Does Body
   Movement Engage You More in Digital Game Play?                  19. Pascarelli, E. Complete Guide to Repetitive Strain In-
   And Why? Affective Computing and Intelligent Interac-               jury, Wiley & Sons, 2004.
   tion, Springer, LNCS 4738, 102-113                              20. Saltzman, A. Computer user perception of the effective-
4. Breazeal C, Wang A, Picard R. Experiments with a Ro-                ness of exercise mini-breaks, Proc ErgoCon, 1998.
   botic Computer: Body, Affect, and Cognition Interac-            21. Slijper, H., Richter, J., Smeets, J., Frens, M. The effects
   tions. 2nd Intl Conf on Human-Robot Interaction, 2007.              of pause software on the temporal characteristics of
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P1817 morris

  • 1. CHI 2008 Proceedings · Personal Health April 5-10, 2008 · Florence, Italy SuperBreak: Using Interactivity to Enhance Ergonomic Typing Breaks Dan Morris, A.J. Bernheim Brush, and Brian R. Meyers Microsoft Research Redmond, WA, USA {dan,ajbrush,brianme}@microsoft.com ABSTRACT any time there is repeated motion of a muscle group under Repetitive strain injuries and ergonomics concerns have strain without rest, the potential for injury exists [19]. become increasingly significant health issues as a growing number of individuals frequently use computers for long Continuous keyboard and mouse use create precisely this periods of time. Currently, limited software mechanisms scenario for information workers. A literature review [2] exist for managing ergonomics; the most well-known are shows numerous studies linking the use of keyboard and “break-reminder” packages that schedule and recommend mouse to RSI. We can expect these problems to be magni- typing breaks. Yet despite the proven benefits of taking fied tremendously as the current generation of children and breaks, such packages are rarely adopted due to the over- teenagers – for whom computer use has been a daily activi- head of introducing periodic interruptions into a user’s ty since early childhood – enters the information workplace. workflow. In this paper, we describe SuperBreak, a break- These individuals have not only been subject to more long- reminder package that provides hands-free interactions dur- term damage due to a lifetime of computer use, but are ing breaks, with the goal of encouraging users to take more combining full days of office computer work with home breaks and enhancing the benefits of those breaks. In a field computer use, which renders them more susceptible to RSI study of 26 knowledge workers, 85% preferred SuperBreak and other health problems caused by extensive typing and over a traditional break-reminder system, and on average mousing. The U.S. Department of Labor, Occupational participants took a higher percentage of the interactive Safety and Health Administration (OSHA) states [18] that breaks suggested to them. Our results highlight the value of “performing this task [computer use] for several uninter- interactivity for improving the adoption and retention of rupted hours can expose the small muscles and tendons of ergonomic break practices. the hand to hundreds or even thousands of activations. There may not be adequate time between activations for Author Keywords rest and recuperation, which can lead to localized fatigue, Ergonomics, RSI, interruptions, physical interfaces wear and tear, and injury.” OSHA has issued a set of rec- ACM Classification Keywords ommendations including, among other things, the follow- H5.2 [Information interfaces and presentation]: User Inter- ing: “High repetition tasks or jobs that require long periods faces – Ergonomics, Input devices and strategies. of static posture may require several, short rest breaks (mi- cro breaks or rest pauses). During these breaks users should INTRODUCTION be encouraged to stand, stretch, and move around. This Repetitive strain injury (RSI) is a general term used to de- provides rest and allows the muscles enough time to recov- scribe soft tissue damage as a result of sustained repetitive er.” We believe that as ergonomic injury becomes a more work, classified by the medical community as a muscu- acknowledged and more universal problem, incorporating loskeletal disorder. In 2001, the National Academy of ergonomics-related features into software environments Science issued a report [16] stating that “Musculoskeletal will be critical as both a solution to a major health problem disorders of the low back and upper extremities are an im- and a marketing feature in all computer software. portant national health problem, resulting in approximately 1 million people losing time from work each year. Conserv- Software packages are now available, and are in some cases ative cost estimates vary, but a reasonable figure is about being distributed by employers, that remind computer users $50 billion annually in work-related costs.” Causes of RSI to take periodic breaks. Some popular examples include range from cooking to driving to keyboard and mouse use; WorkRave1, XWrits2, Stretch Break3, and RSIGuard4. These products remind a user to take short breaks and Permission to make digital or hard copies of all or part of this work for stretch his hands at regular intervals. personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies 1 bear this notice and the full citation on the first page. To copy otherwise, or WorkRave, http://www.workrave.org/ 2 republish, to post on servers or to redistribute to lists, requires prior XWrits, http://www.lcdf.org/xwrits/ 3 specific permission and/or a fee. Stretch Break, Para Technologies, http://paratec.com/ 4 CHI 2008, April 5–10, 2008, Florence, Italy. RSIGuard, Remedy Interactive, Inc., http://rsiguard.com/ Copyright 2008 ACM 978-1-60558-011-1/08/04…$5.00. 1817
  • 2. CHI 2008 Proceedings · Personal Health April 5-10, 2008 · Florence, Italy The ergonomic benefits of taking periodic breaks are both breaks. We then present the results of our field study, and powerful and well-documented [1,2,9,14,15,16,18,19], but we conclude with a discussion of future work since this type of software tends to interrupt workflow, us- RELATED WORK ers frequently ignore their break reminders or turn off this While many researchers have documented the benefits of software shortly after installing it. Furthermore, though taking breaks, two studies [9] and [15] looked specifically breaks do have significant preventative value, a user who is at using software, Stretch Break3, as a means of improving not already experiencing symptoms of RSI is unlikely to rest break completion, while Hedge and Evans [8] ex- even install such software. Various studies have shown that amined how a program called ErgoManager improved vo- despite the common perception of breaks reducing produc- luntary break-taking within two companies. These studies tivity, frequent short breaks actually increase productivity examined how typing break reminders could be effective in and reduce error rates [2]. Balci and Aghazadeh [1] found encouraging break-taking but did not examine the impact of that short breaks significantly increased the speed and accu- break content, which is our focus. racy of both data entry tasks and mental tasks, and Hedge and Evans [8] found a 59% improvement in accuracy across Some previous work in using sensors and interactions to several job classes. McLean et al. [14] and Saltzman [20] improve ergonomics focuses on postural problems: Dunne found that productivity, while not significantly improved, at et al. [6] describe a postural sensor suitable for biofeedback least trended higher when study participants took short applications, and Breazeal et al. [3] present an actuated breaks throughout the work day. Out of 10 studies sur- monitor that can unobtrusively manipulate a user’s posture. veyed, no study reported a reduction in productivity despite However, we know of no other computer systems that use the addition of breaks to the work schedule [2,8]. interactions to motivate good ergonomic habits. In the re- lated area of motivating exercise and overall activity, Con- Given the compelling evidence of the benefits of breaks solvo et al. [5] and Lin et al. [12] used personal awareness while working with a computer, it would be natural to as- and social pressures to increase daily walking habits, while sume that a majority of users take breaks regularly through- Lo et al. [13] used game play to encourage better eating out the day. However, various studies have found that even habits. This area is becoming known as persuasive compu- when participants are specifically instructed to take breaks, ting [7]. Similarly, Bianchi-Berthouze et al. [3] show that voluntary completion of scheduled breaks ranges from 45- body movement can improve players’ engagement in com- 55% [9,15,20]. In some cases, participants were removed puter games and can improve players’ affective experience. from the study group due to never completing a single rec- ommended break [2,9]. SUPERBREAK In this paper we present SuperBreak, a software package Software Architecture that builds upon the traditional “break-reminder” theme. SuperBreak’s core functionality is similar to that of existing SuperBreak seeks to increase break completion by offering break-reminder packages: the user configures typing break interactions during breaks that make the breaks less annoy- durations and inter-break intervals and is informed that a ing and more productive. SuperBreak leverages a video break is pending shortly before it is scheduled to begin. We camera as an alternative input system for use during breaks adopt the terminology of existing software packages, call- and offers a variety of in-break interactions, including read- ing shorter, more frequent breaks “micro-breaks”, and ing documents, playing a game, and watching videos. longer, less-frequent breaks “rest breaks”. A typical confi- guration might schedule a 20-second micro-break every 5 We evaluated SuperBreak in a two-week field study with minutes, and a 5-minute rest break every hour (this is by no 26 information workers. Each person used SuperBreak with means universal; optimal scheduling will depend on a par- interactive breaks for one week, and a control version of the ticular user’s health needs). We focus primarily on micro- software, in which breaks were not interactive, for one breaks in this paper, since we expect most users to either week. All 26 participants, even the 13 who had not pre- leave their desks or do non-computer-based work during viously tried break-reminder software, indicated that they their rest breaks. Between breaks, SuperBreak monitors planned to continue using break-reminder software after the keyboard and mouse activity so that naturally occurring study. Twenty-two participants (85%) preferred SuperBreak breaks are taken into account. In other words, if a 30- with interactive breaks to the control version, and on aver- second micro-break is scheduled to occur every 5 minutes, age participants took a higher percentage of the breaks of- it will only be suggested if there is activity at the keyboard fered in the interactive condition, while typing through or mouse for 5 minutes without any pauses longer than 30 more of the breaks suggested in the control condition. seconds. These data suggest that interactivity can improve the adop- tion and retention of typing-break-reminder software. Where SuperBreak differs from typical break-reminder packages is its support for “Activities” during breaks. An In the remainder of this paper, we first discuss previous “Activity” is a software module intended to run for the du- work directly related to break-reminder software. We then ration of a break, with no keyboard or mouse input. When describe the SuperBreak package, including a description of SuperBreak determines that a break is pending, it selects an the specific interactions currently available to users during Activity according to the user’s pre-configured preferences 1818
  • 3. CHI 2008 Proceedings · Personal Health April 5-10, 2008 · Florence, Italy and prepares the appropriate resources needed for that Ac- With this in mind, SuperBreak includes an activity that uses tivity (e.g. Web content, a video camera) so they are ready a vision-based game to encourage stretching (Figure 1). when the break begins. SuperBreak allows the user to con- The game break uses a standard webcam mounted above figure the Activity-selection mechanism according to his or the user’s monitor to capture a video image of the user at her preferences. For example, a user might configure Su- her desk. As shown in Figure 1, the user sees the image perBreak to offer a preferred Activity 80% of the time, with with one, two, or three on-screen targets superimposed (the an alternative Activity 20% of the time. red and green quarter-circles in Figure 1). To score points, To start a break, SuperBreak provides display resources to the user moves his or her hands up to touch the target(s) and the selected Activity and optionally locks out the keyboard then down off the target(s). When motion is detected within and mouse. Additional notifications are provided to the the target(s) before a short time window elapses, the system current Activity shortly before a break is scheduled to end plays a ‘success’ sound and the user scores points for each and at the end of a break, allowing resources to be de- target hit. Points are deducted if the user fails to activate the allocated and any necessary notifications provided to the target(s) or activates incorrect targets. New targets are then user. After the break is finished, SuperBreak returns the displayed in a different location. The targets are purposely user’s desktop to its pre-break state. The goal of these re- placed such that the user is encouraged to reach above his source management procedures is to ensure that Activities head; this motion rotates the shoulders and encourages are available immediately when a break begins, and that the blood flow to the player’s hands and wrists. user’s desktop state is restored seamlessly when a break Target activation is detected using simple frame-to-frame ends. subtraction. A change image is created for an incoming SuperBreak is implemented in C++ and C#, and runs on camera frame by subtracting the intensity at each pixel from Microsoft Windows operating systems. that observed in the previous frame. A threshold is applied to determine the set of active pixels; if a target area contains ACTIVITIES Activities are intended to encourage the user both to com- a sufficient number active pixels for a threshold period of plete the suggested break and to maintain a healthy ergo- time, it is considered “hit”, and the user is rewarded or pe- nomic posture and activity level during the break. Although nalized depending on the set of targets currently displayed we could imagine a wide variety of options for Activities, and the set of targets currently activated by hand move- we selected four for the study. Two of the Activities – a ment. Throughout our field study, we found this simple gesture-based document-reading system and a gesture- approach to be remarkably robust to varying lighting condi- based game – are active in nature and the user is encour- tions, office configurations, and camera orientations. Image aged to physically move his or her body or arms during the processing is performed using the OpenCV library [17]. break in order to interact with SuperBreak. Both make use Activity 2: Vision-Based Document Reading of computer vision techniques and a video camera to allow We also wanted to experiment with activities that allow the keyboard-free, mouse-free interaction. user to continue working during breaks without using the keyboard and mouse. One productivity task that is particu- The other two Activities are passive in nature, as they do larly well-suited to typing breaks is document reading, not require the user to physically do anything during the which primarily requires passive viewing and periodic ver- break. The first passive Activity allows the user to view tical scrolling. To allow users to defer document-reading online videos. The second passive Activity is the “standard break”, which simply places a text reminder to take a break on the screen. The standard break was designed as a control condition for our experiment, and is consistent with the reminders provided by traditional break-reminder packages. We purposely selected both active and passive Activities, as well as Activities that are either entertaining (game, videos) or productivity-oriented (document-reading), to explore the space of possible Activity types. The following subsections describe these activities in more detail. Activity 1: Vision-Based Game A significant shortcoming of existing break-reminder soft- ware is that it is difficult to enforce or encourage active stretching during ergonomic breaks; many users – eager to continue with their work – will fail to move around during a short break and will maintain the same tense posture they employ while typing, minimizing the break’s effectiveness. Figure 1: SuperBreak’s Vision-Based Game Activity. 1819
  • 4. CHI 2008 Proceedings · Personal Health April 5-10, 2008 · Florence, Italy (a) ( Fig gure 3: SuperBr reak’s Passive V Video-Viewing A Activity. encing is susce differe eptible, such as large-scale b s background movem ment, changes i lighting, etc. in (b) Since bbreaks are ofte too short fo a user to re a com- en or ead plete ddocument, the currently-sele ected documen and the nt scroll p position within that documen persist across breaks. n nt s Activity 3: Passive Vid Presentati y deo ion The passive video presentation A Activity proviides either Figure 2: Sup F perBreak’s Vision-Based Do ocument-Readin ng informmative or enter rtaining conten that require minimal nt es Activity. Within the Activity window (a), the user is presented A n w user innitiative, but s still encourage break-taking This ac- es g. with a list of av w vailable docum ments, a docume ent-viewing areea, tivity l leverages the growing popu ularity of the Web as a and a gesture-based navigati a ion area. The navigation are ea, source of video cont tent to provide a familiar form of pas- e expanded at th bottom of this figure, pr e he rovides feedback sive in nteraction. about the loca a ations mapped to each avai ilable navigatioon command. c SuperB Break’s implem mentation of this activity (Figure 3) asks to their e ta ergonomic brea aks, we have d developed a SSu- allows the user to ch hoose a set of “ “video sources that will s” perBreak Activ that allow vision-based reading of an p vity ws d nd be poll daily for a list of availab videos. Ex led ble xamples in- selecting amon documents (Figure 2). An associated Web s ng ( n clude youtube.com and crackle.com, with the ability to e browser plugin allows the us to queue do b n ser ocuments durin ng select among specifi categories a each source, limited in ic at normal Web br n rowser use for later reading, using an exte r en- our st tudy to sources known to be filtered f office- for sion to the brow s wser’s context menu. approp priate content. Since longer videos tend to contain little co ontent in the f first few second a typical m ds, micro-break During a docum D ment-reading break, a video c b camera is used to would complete befo meaningful regions of a long video ore l detect simple h d hand gestures that allow the user to switch e could b presented to the user. The be o erefore, videos are sorted s among docume a ents, scroll within documen and remov nts, ve by dura ation and are o optimally match to break le hed engths. documents from the current reading list. Th d m r hese actions coor- respond to activ r vation of the icons shown in Figure 2b: ac n cti- Activity 4: Standard B y Break vation of the v v vertical green arrows scrolls the current do a oc- For coompleteness, w mention the “standard br we e reak” here; ument, activati of the hor u ion rizontal black arrows switch hes during a “standard br reak” the user receives a sim mple notifi- among docume a ents, and activa ation of the “X icon remov X” ves cation window that shows the tim remaining during the me th current document from the reading li Once agai he ist. in, break ((Figure 4). Thi break type is used as a con is s ntrol condi- th hese gestures were chosen to encourage t user to rai t the ise tion in the field study described bel y low. his h hands abov his head dur ve ring the break, and can also b be Notifica ations and Use Interface er easily classifie in real-time using the si e ed e imple compute er- We br riefly discuss t types of n the notifications p provided to vision techniqu discussed in the “game break” sectio v ues e on users b SuperBreak and the brea by k ak-management actions a above. In addi a ition to the te echniques use for the gam ed me user ca perform, as they are releva to our field study. an ant break to recogn target activ b nize vation, gesture classification is e further simplif f fied for the do ocument-readin break by r ng re- Twelve seconds befo each suggested break, the user rece- e ore e quiring that on a single ico be activated for a thresho q nly on d old ives an auditory not n tification and a visual remin nder in the period of time b p before navigati commands are issued. Th ion s his lower-rright corner of his primary m f monitor (Figure 5a). This tends to filter out most sour rces of noise t which fram to me- notification contains a “skip” butto that allows the user to on 1820
  • 5. CHI 2008 Proceedings · Personal Health April 5-10, 2008 · Florence, Italy (a) (b) Figure 4: SuperBreak’s “standard break”. prevent a break from starting (this button resets Super- Figure 5: SuperBreak’s Pre-Break Notification Window. (a) Break’s micro-break timer and skips the break entirely) and The pre-break notification presented when interactive breaks a “postpone” button that defers the proposed break for two are available. (b) The pre-break notification presented in our minutes. During our field study, a default Activity was se- field study’s control condition, in which only standard breaks lected at random (game, video, or document); however, in are available. general, the user can specify preferences for how often dif- most 10 minutes of sustained input activity. The keyboard ferent types of Activities should be selected. The pre-break and mouse were not locked during breaks by default. notification window also includes a drop-down box that To evaluate SuperBreak, we used a within-subjects design allows the user to change the Activity that will be used dur- in which participants used SuperBreak on their office PCs ing the upcoming break. During the control condition of the in “interactive mode” for 5 work days and “standard mode” field study this drop-down box was disabled, allowing par- for 5 work days. In interactive mode, SuperBreak randomly ticipants to take only the “standard” break; this simplified selected among the three novel break types (video, game, pre-break notification window is shown in Figure 5b. document) for each micro-break. In standard mode, Super- All four Activity windows (Figures 1-4) also provide a Break was configured to be similar to existing break- “skip” button that allows the user to skip a break that has reminder software, so every micro-break was a “standard already started. break”. Note that the difference in conditions applies only to micro-breaks; micro-breaks were the primary target of FIELD STUDY our investigation and the primary consideration when de- To evaluate the use of SuperBreak and the benefits of inter- signing our Activities, as they are the focus of the relevant active breaks, we recruited 26 participants (12 male) within ergonomics literature. All rest breaks in both conditions our organization5. We selected both participants that either were configured by default to be “standard” breaks, and currently used or had previously tried break-reminder soft- participants were encouraged to use rest breaks to leave ware (6 men and 7 women) and participants that had never their desks or do non-computer work. Participants were tried break-reminder software (6 men and 7 women). Each provided with a USB web camera for the period during participant used SuperBreak for 10 working days (typically which they were using SuperBreak in “interactive mode”, two calendar weeks, but occasionally longer to account for as a video camera is required for two of the three Activities. vacation days). The order in which participants experienced standard or We configured SuperBreak to suggest a 25-second micro- interactive mode was counter-balanced across participants. break after every 8 minutes of interaction. This meant that a All participants completed the study with at least 5 work micro-break was suggested every time a participant typed days in each condition except for two: one participant had or used the mouse for 8 minutes without a 25-second period only 3 work days in the standard condition due to a job of inactivity. A 25-second period of inactivity would reset change during the study, and another had only 4 days in the SuperBreak’s internal countdown to the next micro-break. interactive condition due to unexpected travel. Therefore, how frequently breaks were offered depended on Participants in the study filled out a pre-study survey, a each participant’s typing habits. These defaults were chosen mid-point survey (when they switched conditions), and a based on a pilot study to ensure breaks were proposed fre- post-study survey (after using both versions of Super- quently enough to support the study, but did not overly in- Break). We visited all participants at the beginning of the terfere with participant productivity. Research by Slijper et study to install SuperBreak, at the mid-point to switch con- al. [21] found the number of naturally occurring typing ditions, and at the end to collect logging data from Super- breaks follows a power law, such that increases in sug- Break. During the study period, SuperBreak logged usage gested break length decrease the number that naturally oc- information including the breaks suggested and whether cur, supporting our choice of relatively short micro-breaks. each break was taken or skipped. To account for variations Participants could adjust the length and frequency of breaks in usage time and number of breaks offered across our par- if desired, to maintain consistency with any previous use of ticipants, all log data is analyzed as percentages of each break-reminder software, although we required micro- user’s suggested breaks in each condition. At the end of the breaks to be at least 20 seconds long and to occur after at study, participants received a gratuity for their participation valued at approximately $20. 5 We began the study with 28 participants, but one partici- Demographics pant was unable to complete the study due to hardware Our 26 participants were all between the ages of 20 and 55. problems and another had to travel unexpectedly. All participants worked at our organization, but the study 1821
  • 6. CHI 2008 Proceedings · Personal Health April 5-10, 2008 · Florence, Italy pool spanned a range of occupations, including researchers, we note that this software uses a strict timing mechanism so software developers, and marketing specialists. Our selec- this interval cannot be directly compared with the input- tion criteria aimed to balance male and female participants, based timing used by SuperBreak. and participants who had previously tried break-reminder Results: Questionnaire Data software with participants who had not. Our only additional On the post-study survey we asked participants explicitly selection criterion was that participants work at a single PC which version of SuperBreak (interactive or standard) they during the work day, on which we installed SuperBreak. preferred. The interactive condition was preferred by 85% Each participant reported spending at least 6-10 hours per (22 of 26) of participants. We were also particularly pleased work day at a computer, and 8 reported spending more than that all participants, even those that had not previously used 10 hours per day at a computer. Our participants were long- break-reminder software, reported they would continue time computer users; 11 participants had been using a com- using break-reminder software. Eighteen wanted to use puter more than 20 hours per week for 6-10 years, and the interactive SuperBreak, four wanted the standard version, remaining 15 participants for more than 11 years. and four planned to use other break-reminder software. Eighteen of our participants retained the SuperBreak appli- We collected data on participants’ self-reported experience cation on their computers at the conclusion of the study and concerns with RSI, to inform interpretation of our re- when the researchers offered to uninstall it as part of our sults. In our pre-study survey, participants were asked to final office visit. report their levels of concern about RSI and other related health problems on a four point scale from ‘Not concerned’ When asked why they preferred the interactive version, (1) to ‘Very concerned’ (4). Not surprisingly, given that responses by 11 participants highlighted that the breaks they volunteered for our field study, the median response were more interesting and engaging. Representative com- was ‘concerned’ (3). All participants reported experiencing ments included “love the game, love video. I hate sitting some pain or discomfort they believed was related to com- and just watching a clock tick” (P10), “More fun. Motiva- puter use. Seven participants reported experiencing pain tion to take a break” (P13), and “the breaks were more en- daily, three experienced pain several times per week, four gaging” (P20). Four participants (P5, P12, P25, P28) com- experienced pain several times per month, and the remain- mented on the fact that the encouraged hand movement and ing 12 reported experiencing pain previously but not on a stretching. Three participants (P7, P17, P23) also com- regular basis. Fifteen participants reported they had visited mented on the variety of Activities, as exemplified by: a doctor for a health condition related to working on com- “More variety in the breaks, motivation to take the break puters. When asked to estimate what percentage of their co- through game” (P17), and “I like the variety of activities. It workers had experienced significant discomfort due to made me want to take the breaks.” (P7). computer use, only one participant reported not knowing For the four participants (P4, P16, P19, P27) who preferred anyone who has been affected by ergonomic problems. the standard version, two felt the interactive version was too Most participants (62%, 16/26) reported that between 1% intrusive. For example, P16 said “The standard version was and 25% of their co-workers had experienced problems, not intrusive and worked.” The other two participants each and the remaining nine participants reported that more than found two of the interactive break types annoying. P4 dis- 26% of their co-workers had problems. liked document-reading and video-viewing, while P19 To address concerns about ergonomics, several participants stated “I found that the game/document breaks in the [inter- were currently using non-standard computer peripherals active] version a little annoying and preferred simple breaks such as ergonomic keyboards (12 participants), ergonomic for the short micro breaks.” chairs (7 participants), and ergonomic mice (6 participants). Results: Log Analysis Participants had also made adjustments to their work prac- To evaluate participants’ use of SuperBreak in more depth, tices including incorporating stretching exercises (15 partic- we compared the percentage of breaks taken in each condi- ipants) and alternating or permanently changing the hand tion based on the log files produced by SuperBreak. they use for holding the mouse (9 participants). Six partici- pants had consulted a professional ergonomist to assist in During the study, all participants were offered at least 20 the configuration of their offices. micro-breaks in each condition and the average across par- ticipants was 81 micro-breaks offered in the interactive We asked the 13 participants who had experience with condition and 90 in the standard condition (not a significant break-reminder software some additional questions. Of difference according to a paired t-test). While participants’ these participants, 7 were currently using the break- working style and typing habits impact the number of reminder software provided by our organization and most breaks offered, we feel comfortable that all participants (6 of 7) reported running the software 75-100% of their experienced enough breaks during the study to give us in- work day. When asked how satisfied they were with the formed feedback. We also stress that breaks were only sug- software, the median response was ‘neutral’ on a five-point gested after periods of sustained keyboard or mouse activi- Likert scale. All 7 had the software configured so that more ty, so all of these micro-breaks were suggested when partic- than 15 minutes elapsed between micro-breaks, although ipants were physically present at their computers. 1822
  • 7. CHI 2008 Proceedings · Personal Health April 5-10, 2008 · Florence, Italy Results: Interactive Break Types Interactive Standard In addition to estimating the overall value of interactive % of breaks taken 65.5 49.9 breaks, we assessed the relative effectiveness and subjective perception of each of SuperBreak’s Activities, to inform the % of breaks typed through 3.5 11.4 design of future interactive break-reminder programs. We Table 1: Summary of the key differences between the interac- asked participants Likert-scale questions about whether tive and standard conditions; both differences are significant. they liked each of the Activities, and to rank the Activities in order of preference. Given that breaks offered are an interruption and that pre- vious studies have found that voluntary completion of sche- Game Breaks duled breaks ranges from 45-55% [9,15,20], we expected Overall, the game break was most preferred by our partici- participants would skip a considerable percentage of their pants. Fourteen participants (54%) ranked the game break breaks. We calculated the percentage of breaks taken by first, and the median response when asked to respond to the participants in each condition by dividing the number of statement ‘I liked taking Game Breaks’ was ‘Agree’ (4) on “taken” breaks by the total number of suggested breaks. A a five-point Likert scale from “Strongly Disagree” to suggested break is counted as “taken” if the participant did “Strongly Agree.” Positive comments about game breaks not explicitly skip it (i.e. does not press the “skip” or “post- included “I prefer to move and stretch during breaks so I pone” buttons) and did not continue typing through the liked the game breaks the best” (P24) and “game breaks are break (recall that we did not disable input devices during great and don't really interrupt my work flow” (P10). How- breaks)6. We hypothesized that the percentage of breaks ever, not everyone liked the game breaks. Four participants taken would be higher when participants were using the (P9, P14, P19, P23) made comments about being worried interactive version of SuperBreak. about looking silly or unprofessional while playing the game. For example, P19 stated “I felt I looked strange play- On average, participants took 65.5% of the interactive ing the game breaks – my office is in a location where I am breaks offered compared to only 49.9% of breaks offered in visible to passers-by.” the standard condition (Table 1). A paired-samples t-test shows that these percentages are significantly different Video-Viewing Breaks (p=0.005). Post-study survey responses are consistent with Seven participants (27%) ranked the video-viewing Activity the logging data. On the post-study survey, when asked as their favorite break type. Supporting comments included whether they were more likely to skip breaks in the interac- “I enjoyed the video because it was a few moments of en- tive condition or the standard condition, most participants tertainment. If I'm going to break away from work, that (69%, 18/26) reported that they thought they were more gave the best mental break” (P14) and “The videos were likely to skip breaks when using the standard condition, entertaining and they took my mind away from work to while 5 participants reported that the version had no effect relax for a bit.” (P1). Ten participants commented that they and 3 felt they were more likely to skip breaks in the inter- found it frustrating that interesting videos ended abruptly at active version. Similarly, at the end of each condition we the end of breaks. This highlights an interesting design asked participants what fraction of micro-breaks they be- choice for Activity-based breaks: users were engaged in the lieved themselves to have skipped in that condition. Fol- video content, but an ideal experience within a break may lowing the interactive condition, participants felt they sometimes come at the cost of extending breaks and thus skipped between 25%-49% (median response on a four- risking additional interruption. Some participants’ comput- point scale) while the median for the standard condition ers also had issues caching video appropriately before each was 50 – 74%. These medians are significantly different break so that it started immediately, also highlighting an based on the Wilcoxon test with z=-2.546, p = .011. important point for software implementation of Activity- based breaks: for such a short interactive experience, ap- In addition to taking a smaller percentage of breaks offered propriate preparation of resources before breaks is critical. in the standard condition, participants were also significant- ly more likely to continue typing through breaks – without Document-Reading Breaks explicitly canceling them – in the standard condition than Five participants (19%) rated document-reading breaks as the interactive condition. On average, participants typed their favorite. Positive comments focused on the ability to through 11.4% of breaks offered in the standard condition use breaks constructively, for example “the doc reading was and only 3.5% of those in the interactive condition educational, so I felt it was a good use of my time.” (P8) (p=0.001). and “Document reading is both interactive and potentially a useful way to pass the break, which is why I ranked it first.” (P6). Eight participants commented about challenges using 6 the hand gesture navigation, in particular accidently delet- Breaks in which fewer than 5 keystrokes and fewer than 5 ing documents, which we can address through further re- mouse-click events occurred were considered “taken”; this finement of our gesture set and image-processing tech- allows for cases where a participant took a brief period of niques. However, four participants found it difficult to time to stop typing in response to the initiation of a break. switch contexts quickly enough to read documents during a 1823
  • 8. CHI 2008 Proceedings · Personal Health April 5-10, 2008 · Florence, Italy Activity Percentage of breaks taken We present all statistics for rest breaks using data from both conditions in the study, as there was no difference in the Game 69.6% (28.0) behavior of rest breaks in the two conditions7. Participants Video-viewing 62.6% (29.1) received, on average, 32.5 suggested rest breaks (SD 19.8, min 0, max 69) throughout the course of the study. On av- Document-reading 63.4% (32.3) erage, participants took 25.3% of suggested rest breaks (us- Table 2: Percentage of breaks taken when each Activity was ing the same definition for a “taken” break that we describe suggested, averaged across participants. Parentheses indicate above for micro-breaks). This number is actually somewhat standard deviations. higher than we would have expected, since rest breaks represent a relatively long interruption. micro-break. P10 states: “Document breaks were hard – shifting gears to ingest information from reading material Breaks as Workflow Interruptions and then going back to my work was time consuming and Although we have demonstrated that interactivity during frustrating.” This again highlights the unusual nature of breaks did encourage increased break-taking, a major con- interaction and content design for Activity-based breaks; cern for the design of break-reminder software is the minimizing the cognitive overhead of engaging with break workflow disruption created by breaks or even by break content will leave more time for meaningful interaction suggestions. We do not address this in detail, but point during breaks. briefly to questionnaire results indicating that despite par- ticipants’ desire to continue using break-reminder software, Impact of Activity type on break-taking the median response to the statement “I found this version Table 2 shows the percentages of breaks taken when each of SuperBreak annoying” was ‘Agree’ (4) in the standard Activity was suggested to the user; these numbers are condition and ‘Neutral’ (3) in the interactive condition drawn only from the “interactive mode” data, since Activi- (these medians are not significantly different). Quotes from ties are not used in “standard mode”. The game break re- participants support the notion that break reminders are a sulted in the highest percentage of breaks taken, which is significant workflow interruption. P5 states: “…if I'm typ- consistent with the subjective questionnaire data discussed ing a bunch (and rapidly), I probably don't want to be inter- above, but differences among these percentages are not rupted, and providing me an opportunity to postpone significant after correction for multiple comparisons. doesn't work, because that still breaks my train of thought.” In reviewing participants’ comments, we were struck by the Previous experience with break-reminder software divergence in preferences among participants. Furthermore, We recruited participants so as to balance individuals who numerous comments highlighted the inherent advantage of had never used break-reminder software with those who variety in keeping users’ attention, for example: “variety is had tried break-reminder software in the past or were cur- very important for something one interacts with so fre- rently using break-reminder software. We expected that quently” (P11). Coupled with the fact that no Activity re- participants in the latter category, who had been sufficiently sults in an overwhelmingly higher percentage of breaks motivated at some point to install traditional break- taken, this suggests that future design of Activity-based reminder software, might be more receptive to SuperBreak, breaks should continue to include a variety of potential Ac- i.e. that they would take more breaks and would provide tivities. subjectively more positive responses in both conditions. Rest Breaks Interestingly, we found no effect of previous experience We focus primarily on micro-breaks (short, frequent with break-reminder software on either break-taking proba- breaks) in this evaluation, as the ergonomics literature has bility (in either condition or across conditions) or subjective primarily identified short, frequent breaks as an appropriate response. It may be the case that our expectation of a signif- strategy for reducing the risk of RSI and we have corres- icant effect of previous experience with break-reminder pondingly designed SuperBreak’s Activities under the as- software was unfounded. However, we also note that we sumption that they would be used for short durations. Par- did not directly compare SuperBreak to other break- ticipants in our study were encouraged to use suggested rest reminder packages that participants had used in the past, breaks (longer, less-frequent breaks) to leave their desks or and are thus unable to explore whether even the standard do non-computer work. However, we briefly discuss here condition of SuperBreak was sufficiently different from the data we gathered regarding participants’ habits with other packages, in its scheduling mechanism, UI, system respect to rest breaks. integration, etc., to negate effects of previous experience. During our study, SuperBreak was configured to suggest five-minute rest breaks every hour, using the same schedul- ing policy used for micro-breaks; i.e., a break was only 7 We performed all of the same analyses for comparing rest- suggested if a participant typed for one hour without a five- break-taking across conditions that we describe above for minute gap in activity. SuperBreak presented the “standard micro-breaks, and, as expected, found no significant differ- break” (Figure 4) during rest breaks ences across conditions. 1824
  • 9. CHI 2008 Proceedings · Personal Health April 5-10, 2008 · Florence, Italy DISCUSSION Diversity of Activities is important We now highlight several important themes that emerged While we anticipated that different participants might prefer from our experience designing and studying SuperBreak. different breaks types, we expected that participants might also appreciate variety in SuperBreak’s Activities. Some Interactive micro-breaks were successful At the inception of this project, we realized that the length participants did appreciate variety, however the strength of of a typical micro-break is rather short and we worried preference other participants expressed to us for particular about whether interactivity during that time would be feasi- break types (e.g. only game or only document) was some- ble. That most of our participants preferred the interactive what surprising. For example, P4 states: “if it didn't have condition shows that short activities were possible, and de- the document-reading and video-playing, which were an- sirable, even in 25 seconds. However, in cases where breaks noying, if the interactive version had just been the game- did not start smoothly due to inadequate pre-fetching of playing, with a variety of games, it would have been bet- content, participants expressed significant displeasure. P27 ter.” This highlights the importance of providing a variety states: “The video was my least favorite because it took so of break types to accommodate diverse users. Similarly, long for the video to load that the break was half over be- while we deliberately designed break content that encou- fore it started.” This emphasizes the importance of having rages physical movement, participants’ levels of comfort all necessary resources (e.g. videos, documents) cached doing physical activities varied based on their office envi- before each break so that the break can start seamlessly ronments. with no waiting by the user. We will continue to improve We also note that all of the interactions we have described the pre-break caching of content in SuperBreak; a particular are individual activities, but collaborative or social breaks, design and implementation challenge here is preparing con- such as brief video conferences or collaborative games, tent without introducing computer load that disrupts the might also appeal to many potential users. For example, user even before a break is formally suggested. referring to game breaks, P1 states: “just beating my own One thing that did surprise us was the extent to which par- high score is not as fun as perhaps playing against or chal- ticipants wanted to continue engaging in video-viewing and lenging someone else's score.” We are interested in explor- document-reading micro-breaks beyond the duration of a ing the feasibility and social dynamics associated with simi- break. Despite the workflow interruption, participants ra- larly brief collaborative activities in future work. pidly became engaged in break content and in many cases Scheduling of breaks could be ‘smarter’ desired that content to come to a natural conclusion. This This study focused on participants’ experiences during the highlights another important challenge for the design of breaks provided by SuperBreak, rather than on the schedul- interactive breaks: break activities should be self-contained ing of those breaks. SuperBreak schedules breaks based on and end at natural boundaries, but breaks that are too en- keyboard and mouse activity, rather than on timed intervals gaging can potentially result in decreased productivity. alone, but does not otherwise optimize the scheduling of breaks so as to minimize annoyance or disruption. In both We note that the “game” and “document-reading” breaks conditions, field study participants felt the software pro- made use of interactions that users had not previously expe- posed breaks at inconvenient times. The median response rienced, and the extent to which the success of interactive was ‘Agree’ (4) in both conditions when participants were breaks depended on novelty cannot be assessed by the asked to respond to the statement “This version scheduled present study. We defer a longitudinal evaluation of Super- breaks at inconvenient times.” P25 states: “I hated the mi- Break – which would rule out this effect – to future work. cro breaks. They almost always popped up at inconvenient However, we saw no statistical evidence of a decrease in times, and broke my concentration when I was trying to breaks taken over time throughout the study period (al- focus.” P22 commented “Rest breaks often appeared right though we acknowledge that this is not equivalent to a sta- before I was going to take a long break anyway (e.g., lunch tistical demonstration that such a decrease does not exist). or a meeting), and these I was particularly likely to ignore.” The comparison of interactive and non-interactive breaks is We defer to future work the integration of more sophisti- also affected by a difference in window size among the cated mechanisms for enhancing the input-activity-based break types. Our “standard break” is intended to approx- scheduling of breaks used by SuperBreak. For example, imately represent existing break-reminder software and was digital calendar data is frequently available; this could al- designed accordingly; the activities presented in our inter- low future break-reminder software to avoid proposing active breaks necessitate increased screen space to facilitate breaks when the user is about to leave the office (and thus interactions. In our view, our study shows that participants will implicitly be taking a break) or is conducting an in- chose not to skip interactive breaks despite the relatively office meeting (and thus is unlikely to welcome an interrup- high demands on screen space and consequent intrusiveness tion). Similarly, in-office sensors could be used to deter- on workflow, which strongly supports the notion that inte- mine whether a user is currently engaged in physical activi- ractivity is a strong motivator for break-taking. However, ty that alleviates the need for a break, or is engaged with because screen size is an uncontrolled variable, we cannot, co-workers and thus would probably prefer not to be inter- at present, comprehensively disambiguate all the properties rupted. We also point to related work on using probabilistic of SuperBreak that render it effective. 1825
  • 10. CHI 2008 Proceedings · Personal Health April 5-10, 2008 · Florence, Italy models to assess the cost or annoyance associated with in- 5. Consolvo, S., Everitt, K., Smith, I., Landay, J. A. 2006. terruptions based on computer or sensor state (e.g. [11]); Design requirements for technologies that encourage this work presents a natural basis for the “smart” scheduling physical activity. Proc CHI 2006. of typing breaks. In incorporating any such mechanisms for 6. Dunne, L.E., Walsh, P., Smyth, B., Caulfield, B. Design reducing annoyance, there is clearly a balance that will need and Evaluation of a Wearable Optical Sensor for Moni- to be struck between determining “good” times to interrupt toring Seated Spinal Posture. Proc 10th Intl Symp on a user and making sure that breaks are proposed even when Wearable Computers, 2006. no perfect break time occurs, according to the user’s ergo- 7. Fogg, B.J. Persuasive Technology: Using Computers to nomic needs. We highlight that this area is critical for im- Change What We Think and Do, San Francisco, CA: proving the wider adoption of ergonomic break-taking prac- Morgan Kaufmann Publishers, 2003. tices through break-reminder software, as users who are not immediately concerned about RSI may be unlikely to tole- 8. Hedge, A., Evans, S. J. (2001): Ergonomic Management rate poorly-timed interruptions in the interest of long-term Software and Work Performance: An Evaluative Study. ergonomic benefits. Cornell University Technical Report/RP 2501. CONCLUSION 9. Henning, R.A., Jacques, P., Kissel, G.V., Sullivan, A.B., Our study of SuperBreak with 26 knowledge workers high- Alteras-Webb, S.M.. Frequent short rest breaks from lights the benefits of interactivity and diverse activities dur- computer work: effects on productivity and well-being ing breaks in encouraging people to take micro-breaks from at two field sites. Ergonomics 40(1) (1997). typing. As we believe that the need to encourage people to 10. Horvitz, E., Apacible, J., Koch, P. BusyBody: Creating engage in healthy ergonomic behavior will only increase as and Fielding Personalized Models of the Cost of Inter- people spend more time using computer input devices, we ruption. Proc CSCW 2004. are excited by the response to SuperBreak and its potential 11. Horvitz, E., Apacible, J. Learning and Reasoning about to contribute to a potentially high-impact health issue. Interruption, Proc. ICMI 2003. Additionally, the design of SuperBreak focuses on minimiz- 12. Lin, J., Mamykina, L., Lindtner, S., Delajoux, G., Strub ing continuous typing, but there are other ways in which H.B. Fish’n’Steps: Encouraging Physical Activity with working at a computer can detrimentally impact a user’s an Interactive Computer Game. Proc UbiComp 2006. health. In future work, we will explore mechanisms that 13. Lo, J-L., Lin, T-Y., Chu, H-h., Chou, H-C., Chen, J-h., encourage users to adjust posture or engage in gross physi- Hsu, J., Huang, P. Playful Tray: Adopting Ubicomp and cal movements, reducing potential spinal problems. Simi- Persuasive Techniques into Play-Based Occupational larly, the design of breaks that use non-visual stimuli might Therapy for Reducing Poor Eating Behavior in Young leverage the benefits of interactivity demonstrated in this Children. Proc UbiComp 2007. paper while encouraging users to look away from the moni- 14. McLean, L., Tingley, M., Scott, R.N., and Rickards, J. tor during breaks, reducing the potential for eye strain asso- Computer terminal work and the benefits of micro- ciated with computer use. In both of these scenarios, using breaks. Applied Ergonomics 32(3) (2001). computer vision techniques may allow us to provide closed- loop feedback about posture or gaze and encourage corres- 15. 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