Research & Development
What is the MouseKeyDo System?
The MouseKeyDo System is a health and safety training program
developed by Dr. Norman Kahan to specifically address
and prevent computer-related repetitive stress injuries (RSI). Based on
clinical practice, research, and scientific methodology, the System
includes an interactive manual and CD-ROM that teach a complete set of
techniques for workplace setup, sitting, mousing, keyboarding, and
laptop use. The program is self-guided and fully portable, making
training completely flexible and relatively inexpensive.
Order the MouseKeyDo system or
find a MouseKeyDo provider near you.
On what is the MouseKeyDo System based?
A significant amount of computer-related RSI is caused by improper work
habits and poor computer operator technique, despite a well-designed
ergonomic office environment (Punnett, 1994). The MouseKeyDo System is
designed to address the factors beyond office equipment that cause and
The program was founded in part through Dr. Kahan's medical research and clinical experience working with patients in computer-centric Silicon Valley, where RSI is a common work-related complaint. His personal experience learning to play piano also significantly influenced the program's keyboarding techniques. His research is summarized in a PowerPoint presentation developed by him, which he has presented to the American Occupational Health Conference (AOHC), The American Society for Surgery of the Hand (ASSH), and the American Society of Hand Therapy (ASHT). Much of the development process is summarized in a two-part article Dr. Kahan wrote for the professional journal Occupational Medicine about the causes of RSI, guidelines to prevent it, and corrective measures to alleviate it. You may download the PowerPoint presentation with its transcript and references, along with both parts of the article from this website (requires Adobe Acrobat Reader).
"Computing Without Pain: New Technique for the Treatment of Computer-Related Repetitive Stress Injuries (RSI)," a PowerPoint presentation along with transcript, presented and developed by Dr. Kahan, summarizing his research.
In addition, Dr. Kahan drew from more than 50 years of research into
ergonomics, orthopedics, and physiology. A list of more than 150
references is available here.
"Technique Addresses Computer-Related RSI, Part One." Clinical Care
Update: Occupational Medicine, Volume 8, Number 17, March 11, 2002.
"Technique Addresses Computer-Related RSI, Part Two." Clinical Care
Update: Occupational Medicine, Volume 8, Number 18, March 25, 2002.
[link to PDF]
Has the MouseKeyDo System been studied for efficacy?
Researchers have conducted a three-phase investigation into the MouseKeyDo System.
Phase I evaluated the treatment outcome of 102 workers' compensation
claimants who underwent individual MouseKeyDo training in a clinic-based
Phase II evaluated the training experience of 81 injured employees who
received MouseKeyDo training through a worksite-based group intervention
program. Each was evaluated before, immediately after, and 1.3 years
after the training.
Phase III further evaluated seven subjects from Phase II by examining
muscle activity (as measured by surface electromyography (surface EMG)
and joint ranges of motion in the upper limb and neck while they used a
keyboard and mouse. Subjects were simultaneously measured for all
variables both before and after the training, correlating pain and
Phase III subject fitted with surface EMG
recording electrodes. Each strap secures two electrodes on the skin
surface of the arm and one over the trapezius muscle.
An occupational therapist certified in hand
therapy uses a handheld Goniometer to measure joint range of motion on a
Phase III subject.
What was the outcome of the study?
Among subjects in Phase I and Phase II:
- The percentage of patients reporting less pain and the same or
better function immediately after undergoing MouseKeyDo training, by
- Phase I - 85%
- Phase II - 89%
- Phase III - 100%
- On average, patients in Phase I reached maximum medical improvement and
were declared "permanent and stationary" at six months. After training,
the average time a patient could work on a keyboard increased by one
hour. Those completely unable to type due to pain before training could
type for 3.6 hours after training.
- Group training in Phase II was as effective as individual training in
Phase I and improved group satisfaction at the worksite.
- Phase II participants reported persistence of skill, less pain, and the
same or better function at 1.3 years follow-up.
Among subjects in Phase III:
- Patients learned the MouseKeyDo System 50 to 75 percent faster using the
manual and CD-ROM than without.
Where can I find more details of this study?
- Every patient reported less pain in all body parts recorded -- neck,
forearm, and wrist -- after training.
- Surface EMG decreased in the wrist and forearm muscles after training
- Surface EMG increased in the neck, scapula, and trapezius muscles
after training, without increases in neck pain.
- Joint range of motion changed toward mid-range, with wrist, elbow, and
shoulder joints working collectively in the middle (most comfortable) of
their full or capable ranges of motion. Patients avoided extreme angles,
such as twisting the wrist sideways or reaching from the shoulder,
achieving motion at the lowest level of joint stress and muscle tension.
Complete details are available in a two-part article published in the
journal Occupational Medicine. You may download both parts of the
article from this website (requires Adobe Acrobat Reader).
"Outcomes of Mouse-Keyboard Training, Part One." Clinical Care Update: Occupational Medicine, Volume 10, Number 15, February 9, 2004.
"Outcomes of Mouse-Keyboard Training, Part Two." Clinical Care Update: Occupational Medicine, Volume 10, Number 16, February 23, 2004.