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A Reclining Workstation for a Person with Thoracic Outlet Syndrome

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This consumer is a large woman with thoracic outlet syndrome who experiences difficulty with sitting as well with accessing a computer. Her therapist specified very particular positioning constraints including: a chair allowing her to bring her elbows behind the mid-coronal plane and with a 20 degree back recline; adjustable monitor arm to accommodate 5 to 10 degrees of cervical extension; lap-level keyboard tray with wrap-around features to place hands for typing adjacent to the anterior, superior iliac spines with a negative incline; low force separable keyboard, low force mousing, etc.


Mock-up Workstation in Lab
Mock-up Workstation in Lab
Finished Workstation
Finished Workstation

I had her come into our lab where I mocked up an "ideal" workstation for her which included a Soma chair with TBT-3 back, significant back angle, and overall recline, a 12"-high footrest (Workrite Footrester #215), together with a Comfort ErgoFlex keyboard, and a Cirque SmartCat trackpad. (She was evaluated for speech recognition software.)

Although mocking up a system was challenging on its own, designing a work station that could provide the all-around support she needed while allowing her to get in and out required significant design effort. In addition to a computer with speech recognition software and the above-mentioned keyboard and mouse, the following setup was devised:

1.When reclined in her chair, she cannot push herself away from the desk, so the surface had to move away from her. I chose a design where a 48"-wide by 24" deep support surface attached to a height-and-angle adjustable Idea@Work Retractable Secondary Surface Lift on a dual track was mounted underneath a higher table. (Having a table on wheels holding the keyboarding surface roll under a higher table with the monitor arm and computer would not provide enough adjustment.)

2.The table above it was a HON-ESR3060 30x60 height-adjustable Activity Table with no cross bars or modesty panel, modified to have an underneath clearance of 35" (3/4" steel pipe was used in place of the existing telescoping leg extensions.)

3.To provide the support she needed, the work surface with a semicircular cutout wrapped around her to the point where she could not get out, even when the surface was retracted underneath the table. To accommodate this, the 12" deep padded arm supports on either side were hinged so she could bring them up to vertical for better access. (This also allowed for angle adjustability at her elbows.

4.An ErgoTron LX LCD monitor arm that could extend out towards her from the upper table while she was reclined back, was mounted to a board that hooked over the front and back of the table (rather than bolting it to the table) to allow for lateral repositioning as needed.

5.A Levo adjustable bookholder on a wheeled stand was positioned next to the table for added flexibility.

Cost Analysis

The cost of the modification (not counting the chair, chair mat, footrest, bookholder, computer system and monitor, or assessment) was approx. $750 in materials and 12 hrs labor.


Ray Grott, MA, ATP

RET Project, San Francisco State University