想脫鞋? 站穩了別坐下更別倒下大綱

If you find yourself needing to sit down to take off your shoes, it might be time to start paying attention to your sense of balance.

如果你發現自己脫鞋時必須坐下來的話，你可能到了該關注身體平衡問題的時候了。

People don't usually think about balance until they fall, but little signs such as relying on handrails to go up and down stairs can be early warnings that stability is starting to go, says Jason Jackson, a physical therapist at Mount Sinai Hospital in New York. These changes won't show up on the formal assessments that doctors use for people with balance disorders, such as the Berg and Tinetti scales. For most people, good ways to gauge include the need to lean on armrests when getting out of a chair or feeling wobbly while standing with feet very close together.

紐約芒特西奈醫院(Mount Sinai Hospital)理療師賈森・傑克遜(Jason Jackson)說，人們總是到了摔倒的時候纔想到身體平衡問題，但是一些細微的信號比如上下樓需要緊握扶手可能是肢體穩定性下降的早期信號。這些小的變化不會體現在醫生用於平衡失常者的正式評估表上，例如伯格氏平衡量表(Berg scale)和蒂內提測試(Tinetti test)。對於大多數人來說，合理的自測標準包括從椅子上站起來是否需要依靠扶手，或者兩腳距離很近站立時是否感到晃動。

An important age range for improving balance is the 30s and 40s. While most people don't develop serious balance problems until well into their 50s, experts recommend that otherwise healthy people keep active and do simple exercises to challenge the body and keep steady into old age.

增強平衡感的重要年齡段是30到40歲。儘管大多數人50好幾之前不會有嚴重的平衡問題，專家還是建議健康人士經常活動、做一些簡單的練習來挑戰自身，步履穩健地步入老年。

In the U.S., falls are the leading cause of injury for people over 65, according to a 2005 report by the Centers for Disease Control and Prevention. Every 17 seconds, someone in this age group is treated in an emergency room for a fall. Every 30 minutes, one will die from injuries caused by falling.

美國疾病控制與預防中心(Centers for Disease Control and Prevention)2005年的一項報告顯示，在美國，摔倒是導致65歲以上人士受傷的主要原因。每17秒就有一個該年齡段的人因摔倒而去急救室接受治療。每30分鐘就有一個人死於摔倒造成的創傷。

Balance is controlled by the brain's cerebellum, a region of the brain that is responsible for movement and coordination. According to McGill University physiology professor Kathleen Cullen, the cerebellum coordinates information from three systems: the visual, the vestibular (or inner ear) and the proprioceptive (or sense of body position). In addition, it works with the spinal cord to adjust for unexpected information -- for instance, a slippery surface -- and maintain balance.

平衡由小腦控制，這是腦部負責運動和協調的區域。麥吉爾大學(McGill University)生理學教授凱瑟琳・卡倫(Kathleen Cullen)表示，小腦通過三個系統處理信息：視覺系統、前庭系統（或者說內耳）以及本體感受系統（或者說對身體姿勢的感知）。另外，小腦還與脊髓相配合來應對意外情況──比如光滑的地面──並保持平衡。

All these systems start to erode after 40. And people also become more sedentary as they age and begin to rely on the visual system more heavily. The problem: The visual system doesn't work as quickly as the vestibular system, so people start getting shaky and risk falling. 'People then don't trust their own balance, so they become more sedentary,' says Dr. Cullen. 'And by becoming less active, you actually lose the ability to use or take advantage of [sensory information], and your balance gets worse.'

這些系統在40歲以後就開始退化。隨着年齡的增長，人們坐着的時間越來越長，也開始更加依賴視覺系統。問題在於，視覺系統的反應速度不及前庭系統，所以人們就開始站不穩甚至摔倒。卡倫博士說：“於是人們就不再相信自己的平衡感，所以更願意坐着。並且由於活動減少，你實際上失去了利用感官信息的能力，平衡感就更差了。”

Exercises can isolate these different systems and make the body work harder to keep them in top shape. Experts suggest doing exercises in a couple of five- to 10-minute bouts each day.

鍛鍊可以強化不同的系統，也會促使身體努力運轉從而讓這些系統保持最佳狀態。專家建議每天以五到10分鐘爲一組，鍛鍊幾次。

For people in cities with public transportation, avoid clutching tightly on to the poles in subway cars. A lighter grip will challenge your body to maintain stability on its own. Another option: Walk on many differences surfaces, says Mr. Jackson of Mount Sinai. When at a park, for example, alternate between walking on the pavement and the grass because the unstable surface will make the muscles work more.

在城市裏乘坐公共交通的人儘量不要緊握地鐵車廂裏的扶手杆。少用扶手杆會促使你依靠自身來保持平衡。芒特西奈醫院的約翰遜說，另一個方法是在不同的路面上行走。例如，在公園的人行道上和草坪上交替行走，因爲路面的變化會增加肌肉的運動量。

Other exercises:

其他鍛鍊：

-- Stand and lift your right arm straight out in front of you while swinging your left leg back and forth, and vice versa, to work on coordination, says Mr. Jackson. Then try it with your eyes closed to help decrease your reliance on vision for balance.

約翰遜說，身體直立並將右臂向前平伸，同時前後擺動左腿，反之亦然。這是爲了鍛鍊協調能力。之後試着把眼睛閉上來減少對於用視覺感知平衡的依賴。

-- Strengthening the hips -- an important component of preserving balance -- can be done next to the kitchen counter, says Jennifer Brach, an associate professor of physical therapy at the University of Pittsburgh. Hold on to the counter while standing on one leg and lift the other leg to the front, then the side, then back and then up with your knee bent like you're marching. This works four separate groups of muscles in the hips: the hip abductors, hip adductors, hip extensions and hip flexors. (These muscles can also be strengthened by using the hip abductor and adductor weight machines at the gym.)

匹茲堡大學(University of Pittsburgh)理療學副教授珍妮弗・布拉克(Jennifer Brach)說，強健臀部肌肉，這是保持平衡感的重要環節，這項運動可在廚房操作檯邊完成。手扶着操作檯，同時單腿站立，另一條腿前伸、側伸、後伸，再擡腿屈膝，就像列隊行進一樣。這樣能夠使臀部的四組肌羣得到運動：臀部外展肌、臀部內收肌、臀部伸肌和屈肌。（這些肌肉也可通過健身房的臀部伸展器械進行鍛鍊。）

For office workers, simply getting up from a chair 10 times in a row can be useful, says Mr. Jackson. Alternate between getting up with your feet in wide stance, which provides more support, and getting up with a narrow stance with your feet touching.

傑克遜說，對於白領一族，只要連續從椅子上起立10次就很有效果。先將雙腳分開一定距離起立，這會給身體提供更多支撐，再雙腳併攏起立，兩者交替進行。

'It's much more difficult to maintain balance with a narrow base of support, so those little variations test your coordination,' he says.

他說：“雙腳併攏時保持平衡要困難得多，所以雙腳距離的變化就是考驗你的協調性。”

Good balance also requires 'exercise for the nervous system,' says Dr. Brach. 'To practice their balance, people should be working with timing and coordination,' she says.

布拉克博士說，良好的平衡感也需要“鍛鍊神經系統。爲了訓練平衡感，人們應該在節奏感和協調性方面下功夫”。

An exercise she has patients do in her clinic is the 'stepping pattern.' Stand with feet shoulder-width apart. Put the right foot in front of the left, and shift weight onto the front foot so that the left heel is off the ground. Do this 10 times. Then repeat with the left foot in front of the right.

她在診所裏對病人做的一項訓練是“步伐練習”。兩腳與肩同寬站立，再將右腳放在左腳前面，將身體重心移到右腳，從而讓左腳跟離地，重複做10次。之後將左腳放在右腳前面做相同的動作。

For a more difficult variation, alternate sides -- go right-left-right-left -- to get your body accustomed to switching weight more quickly, she says. You can also do make the move more challenging by stepping backward.

她說，另一種難度更高的版本是左右移動，按照左-右-左-右的節奏，從而讓身體更快地適應重心的轉換。你也可以向後移動，使其更具有挑戰性。

The stepping pattern is similar to moves found in ballroom dancing and 'forces you to think and coordinate and time your body,' says Dr. Brach. Exercises that encourage learning new moves and adjusting to the environment -- such as tennis or gymnastics, as opposed to long-distance running -- may be better for maintaining balance. But, says Dr. Brach, 'we don't have the research to say for sure that one is better than another.'

布拉克博士說，這種步伐與交誼舞的步伐相似，“讓你思考、調整身體並把握節奏”。可以讓人學會新的動作並增強環境適應能力的運動──例如網球和體操──似乎更適合訓練平衡感，長跑則不太適合。但布拉克博士也說：“沒有研究確切表明某一項運動優於另一項。”

Walking in a circle or oval around the living room or backyard can be good practice because it is more challenging to walk on a curve.

在客廳或者後花園繞圈走也是不錯的鍛鍊，因爲沿着弧線行走對身體更具挑戰性。

There is also a mental component to regaining balance, says Arlene Schmid, an associate professor of occupational therapy at Colorado State University. This mental aspect is a bigger factor for people with impaired balance due to advanced age or illness.

科羅拉多州立大學(Colorado State University)作業療法學副教授阿琳・施密德(Arlene Schmid)說，心理因素也影響着平衡感的恢復。對於因年齡和疾病造成的平衡感下降的人來說，心理因素的影響更大。

In a study published by the medical journal Stroke in 2012, Dr. Schmid's team taught yoga to post-stroke patients for eight weeks. Of the 34 patients, 19 initially had balance impairment as measured on the Berg balance scale. After training, 11 had impaired balance.

在一項研究中，施密德博士的團隊對中風康復患者進行了爲期八週的瑜伽教學。在34名患者中，19人經伯格氏平衡量表評估爲平衡感受損。在訓練過後，平衡感受損的人數減爲11人。該研究論文於2012年發表於醫學雜誌《卒中》(Stroke)。

Dr. Schmid said she believes the patients were successful in large part because they felt confident they could do the movements.

施密德博士說她認爲這些患者的成功很大程度上是因爲他們對自己能夠取得進步抱有信心。

'We really were trying to focus on making everyone feel successful from day one to build their confidence, so for the first few weeks we only had sitting postures,' she says.

她說：“我們真的非常努力地讓每個人從第一天起就獲得成就感，從而建立起信心，所以在最初的幾周我們都只練習了坐姿。”

Yoga can boost balance ability because it increases flexibility and its many poses integrate movements that strengthen a lot of different muscles, including those in the hip, says Dr. Schmid. But the emotional component is key.

施密德博士說，瑜伽能夠增強人的平衡感，因爲它增進了靈活度，同時瑜伽的各種體式融合了可以強化各種肌羣的動作，包括臀部的肌肉。但是情感因素纔是關鍵。

'People are afraid of falling and they don't want to move anymore -- and the biggest preventative piece is just not being afraid to get moving,' she says.

她說：“人們害怕摔倒就不再活動了，而最好的解決辦法就是不要害怕。”

Balance-Boosting Exercises

增強平衡感的練習

Walk in a circle or oval. Make the circle or oval smaller and smaller so the curve becomes tighter.

繞圈（正圓或橢圓）走，並且讓圈子越來越小，這樣弧度也就越來越大。

Stand on one leg (hold on to a counter if you need to) and do leg lifts to the front, side, back, and up like you're marching. This exercises four groups of muscles in your hips, which are important to preserving balance.

單腿站立（如果需要的話可手扶檯面），另一條腿前伸、側伸、後伸，再擡腿屈膝，就像列隊行進一樣。這些動作能夠使臀部的四組肌羣得到運動，對於保持平衡感非常重要。

Get up from your chair 10 times in a row without leaning on arm rests. Alternate between your feet in wide stance and close together. Make it more difficult by closing your eyes.

從椅子上連續起立10次，並且不依靠扶手。雙腳分開、併攏交替站立。閉上眼睛來增加難度。

Put five cones (or other objects) in a straight line and weave between them.

將五個圓錐形物體（或者其他東西）排成一條直線，並在其間繞行。

Stand with feet shoulder-width apart. Put your right foot in front of your left, and shift your weight onto your right foot so that the left heel is off the ground. Do this 10 times. Repeat with left foot in front of the right foot. Variations: Do the exercise alternating feet or stepping backward or with your eyes closed.

兩腳與肩同寬站立，將右腳放在左腳前面，將身體重心移到右腳，從而讓左腳跟離地，重複做10次。之後將左腳放在右腳前面做相同的動作。變換形式：左右腳替換，或者向後移動，或者閉上眼睛。