I absolutely love Thimble Lady's hoop. It is hands-free & maintains a consistent tilt to help me achieve nice, even stitches in the most comfortable position. I have loads of neck & back problems, but have no issues working with her hoop. I use a modified version of her quilting method -- working with an Aunt Becky -- so I keep the sandwich very, very loose in the hoop.
http://www.thimblelady.com/hand-quil...mbleladys-way/