A Postural Awareness System for the Cervical Spine

Human-Computer Interaction, Fall 2013

Team NeckGraffe won 3rd place in the 2014 CHI Student Design Competition in Toronto!

Team members:
Rushil Khurana
Tulika Saraf
Shan Li

The Problem

Common, complex, and burdensome to individuals and society alike, neck pain is estimated to affect more than 70% of the population at some point in life and between 12-34% of the population at a given time, with one study finding that 45.5% of office workers experienced neck pain in a 12-month period (Cagnie, Dannee, Van Tiggelen, Loose, and Cambier, 2007). Among other factors, frequent computer use is commonly associated with increased risk of neck pain (Hakala, Rimpela, Saarni, and Salminen, 2006; Cagnie et al., 2007; Taieb-Maimon, Cwikel, Shapira, and Orenstein, 2012).

Understanding the Problem Space

Healthy posture may be part of the solution to the widespread problem of neck pain. Improvements in posture are associated with decreased musculoskeletal symptoms (Falla, Jull, Russell, Vicenzino, and Hodges, 2007; Taieb-Maimon et al., 2012). Users have responded positively to personalized interventions that facilitate postural awareness using real-time data. While ergonomic education can provide short-term benefits, interventions involving ongoing feedback and instruction to reinforce the desired behavior have been shown to improve ergonomics and maintain those improvements over time (Taieb-Maimon et al., 2012).


Our four-person team designed a postural reminder system to help users keep track of and improve their neck posture. We created a prototype for a mobile application to remind the user when he or she assumed an unhealthy posture, and conceptualized a wearable device to be affixed to the user’s neck. The wearable sensor would contain an accelerometer and gyroscope to measure cervical positioning and a vibration motor to give gentle buzzing (duration and intensity fully customizable) upon detection of unhealthy forward head posture. The app helps the user track their current and historical postural data and even includes levels-based badges and social features to keep users motivated to stand tall.

I conducted research on links between posture and pain, designed the mobile app mockup, contributed to prototype development, and helped design the evaluation.

Storyboard of how the NeckGraffe system would be used

Storyboard for body sensor and mobile interface

Mobile app mockups in Balsamiq

Current Posture screen
Current Posture: Shows current posture in relation to an ideal healthy posture, with brief descriptions of desirable or undesirable postural elements. Icon in status bar notifies user of current posture.
Track Posture screen
Track Posture: Visualizes tracked postural data over an adjustable period of time. Tracking can be further customized by location to see different postural patterns while at home, work, or school.
Learn screen
Learn Posture: Educational and instructional resources for users to learn about the importance of posture, how to maintain a healthy posture, and selected exercises for stretching and strengthening.
Settings screen
Settings: Allows user to customize and edit system behavior, notifications, and personal information, learn more about the system, and get help when necessary.

Wearable neck sensor concept

Body sensor design

Initial Axure prototype

Daily Track screen
Posture Tracking: Data about the user’s healthy and unhealthy posture can be displayed by the day, week, or month.
Healthy Current Posture screen
Current Posture (Healthy): Home screen displays the user’s real-time posture and a description of why it is healthy. Below are the user’s current badge(s).
Unhealthy Current Posture screen
Current Posture (Unhealthy): If the user’s current posture is unhealthy, the tips offer suggestions for improvement.
Badges Leaderboard screen
Badges Leaderboard: The rankings show friends’ names, pictures, number of achievements, and current badge.
Badges Earned screen
Badges Earned: The screen lists earned badges and goals (e.g., maintain healthy posture for 15 min) to earn the next badge, and the option to check in to see friends’ achievements.
Learn screen 1
Learn: Educates users about importance of healthy posture.

Redesign for CHI

We submitted our design to the 2014 CHI Student Design Competition. After we learned that NeckGraffe was one of the 12 semifinalists accepted out of 60-some entries, we decided to update the design to conform more closely to iOS standards. I co-wrote and co-edited the final paper with Rushil, while Tulika was in charge of the redesign.

As mentioned above, we won 3rd place.

Current posture: UnhealthyCurrent Posture: HealthyTrack: WeeklyBadges: Logged inLearn: First tipSettings

CHI Proceedings Article:
Khurana, R., Marinelli, E., Saraf, T., & Li, S. (2014). NeckGraffe: A postural awareness system. In CHI ‘14 Extended Abstracts: ACM SIGCHI Conference on Human Factors in Computing Systems Proceedings (pp. 227-232). DOI: 10.1145/2559206.2580936


Cagnie, B., Danneels, L., Tiggelen, D. V., Loose, V. D., & Cambier, D. (2007). Individual and work related risk factors for neck pain among office workers: a cross sectional study. European Spine Journal, 16(5), 679-686.

Falla, D., Jull, G., Russell, T., Vicenzino, B., & Hodges, P. (2007). Effect of neck exercise on sitting posture in patients with chronic neck pain. Physical Therapy, 87(4), 408-417.

Hakala, P. T., Rimpelä, A. H., Saarni, L. A., & Salminen, J. J. (2006). Frequent computer-related activities increase the risk of neck–shoulder and low back pain in adolescents. European Journal of Public Health, 16(5), 536-541.

Taieb-Maimon, M., Cwikel, J., Shapira, B., & Orenstein, I. (2012). The effectiveness of a training method using self-modeling webcam photos for reducing musculoskeletal risk among office workers using computers. Applied Ergonomics, 43(2), 376-385.