Tips for Wellness in a Virtual World
Bonnie Boenig, M.Ed, OT/L, C/NDT
Tele-practice, since March 2020, when, due to the COVID-19 pandemic clinicians worldwide began exploring virtual therapy services, has become an acceptable choice for delivering therapy to patients and clients of all ages. This shift to sitting in front of a computer screen for hours at a time has also been a different physical experience for clinicians, who, during a typical workday, would have been active and moving.
Clinicians now are in the habit of conducting virtual therapy, holding online meetings, and teaching remotely. Certain providers offer teletherapy services exclusively. Meetings often become stressful due to consecutive scheduling and the requirement for sustained focus during virtual sessions. Most of us have begun to figure out ways to adjust to sedentary hours of virtual practice, attending meetings, and hours of clinical documentation using a computer or digital device, however many of us have also experienced physical symptoms because of it, and some symptoms may not have been recognized as related to excessive screen time.
Occupational therapists understand ergonomics and the importance of a work environment that supports body alignment and functional needs, the sensory impact on the overall nervous system, neuromuscular and neuropsychological health, and how prolonged lack of movement and staying in one position can negatively affect muscular flexibility and contribute to aches and pains. Below are points of consideration to use as we as clinicians look to support our own physical and mental health as well as that of patients, clients, students, and co-workers who engage in extended screen time.
Physically, by sitting for prolonged periods of time in front of a screen, our bodies begin to take on a passive posture. This posture often involves trunk slumping and neck hyperextension at the upper spine. Providing therapy virtually and attending meetings for hours at a time create a situation whereby our physical bodies tend to fall into gravity, resulting in slouching and hunching, which increases strain on the back, neck, and shoulders and creates tightness in muscles associated with trunk flexion. Hunching over a laptop can lead to neck strain and tightness throughout neck musculature which will contribute to headaches, malalignment through the jaw, and forward tipping of the shoulder girdle. Ergonomically, the placement of the computer screen is critical to encourage upright alignment of trunk and face forward position of head and upper body. Placing the computer up on a raised surface in front of you or using a monitor so the screen and camera are directly in front of your face will prompt upright sitting to ensure positioning clearly on the screen. Use of an external keyboard can aid with positioning upper extremities, particularly wrists and hands to support good alignment. Whole body stretching routines can help counteract the physical, sensory, and mental health effects of prolonged screen time by maintaining flexibility and good posture. Upper body strengthening is also important to support a postural active sustained position while in front of the screen for lengthy periods of time.
Eye strain is another obvious impact from staring at a computer screen for too long. When staring at screens, people blink less often than they do during face-to-face interaction, and less blinking can result in dry eyes and can leave a person feeling fatigued. To minimize eye strain, follow the 20/20/20 rule for resting your eyes, as established by Dr. Jeffrey Anshell. (“Preventative Eye Care | Eye Care Center of Northern Colorado”) The rule suggests working for 20 minutes, followed by staring at an object at least twenty feet away for at least 20 seconds. This allows the eyes to rest and refocus. Face-to-face and virtual meetings differ in eye comfort and cognitive effort. During an in-person meeting, you only look at the speaker, or the visual they display on a screen. During a virtual meeting, in a gallery view, you look at every single person as well as yourself. This creates visual overload. The eyes and brain are trying to process too many individual things instead of seeing a singular image on the computer screen. To add to the confusion, everyone is also looking back at you. It is like watching television and having the people on the screen watching you. One suggestion to alleviate this visual stress and sensory/mental overwhelm is to change the view from gallery to speaker, although there are situations where the nature of the meeting does not allow for such accommodation. To reduce sensory overload, disable participants’ video so only the presenter is visible.
Developing and incorporating wellness routines and ergonomic principles into our own digital experiences will alleviate risk of physical impact over time and sharing these suggestions and implementing them in our treatment protocols will also benefit successful therapeutic outcomes for patients and clients we serve. ■
References
Khumukcham A Devi, Sudhakar K. Singh. The hazards of excessive screen time: Impacts on physical health, mental health, and overall well-being. J Edu Health Promotion 2023 Nov,27;12:413.
Preventative Eye Care | Eye Care Center of Northern Colorado, https://eyecaresite.com/2023/04/preventative-eye-care/.
Vaishnavi S. Nakshine, Preeti Thute, Mahalaqua Nazilkhatib, Bratati Sarkar. Increased Screen Time as Decline of Physical, Psychological Health and Sleep Patterns: A Literary Review. Cureus. 2022 Oct 8:14 (10): e30051, doi:10.7759/cureus.
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