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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(fā)現(xiàn)自己脫鞋時(shí)必須坐下來(lái)的話，你可能到了該關(guān)注身體平衡問(wèn)題的時(shí)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(yī)院(Mount Sinai Hospital)理療師賈森・杰克遜(Jason Jackson)說(shuō)，人們總是到了摔倒的時(shí)候才想到身體平衡問(wèn)題，但是一些細(xì)微的信號(hào)比如上下樓需要緊握扶手可能是肢體穩(wěn)定性下降的早期信號(hào)。這些小的變化不會(huì)體現(xiàn)在醫(yī)生用于平衡失常者的正式評(píng)估表上，例如伯格氏平衡量表(Berg scale)和蒂內(nèi)提測(cè)試(Tinetti test)。對(duì)于大多數(shù)人來(lái)說(shuō)，合理的自測(cè)標(biāo)準(zhǔn)包括從椅子上站起來(lái)是否需要依靠扶手，或者兩腳距離很近站立時(shí)是否感到晃動(dòng)。
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(qiáng)平衡感的重要年齡段是30到40歲。盡管大多數(shù)人50好幾之前不會(huì)有嚴(yán)重的平衡問(wèn)題，專家還是建議健康人士經(jīng)常活動(dòng)、做一些簡(jiǎn)單的練習(xí)來(lái)挑戰(zhàn)自身，步履穩(wěn)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(guó)疾病控制與預(yù)防中心(Centers for Disease Control and Prevention)2005年的一項(xiàng)報(bào)告顯示，在美國(guó)，摔倒是導(dǎo)致65歲以上人士受傷的主要原因。每17秒就有一個(gè)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(gè)人死于摔倒造成的創(chuàng)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(fù)責(zé)運(yùn)動(dòng)和協(xié)調(diào)的區(qū)域。麥吉爾大學(xué)(McGill University)生理學(xué)教授凱瑟琳・卡倫(Kathleen Cullen)表示，小腦通過(guò)三個(gè)系統(tǒng)處理信息：視覺(jué)系統(tǒng)、前庭系統(tǒng)（或者說(shuō)內(nèi)耳）以及本體感受系統(tǒng)（或者說(shuō)對(duì)身體姿勢(shì)的感知）。另外，小腦還與脊髓相配合來(lái)應(yīng)對(duì)意外情況──比如光滑的地面──并保持平衡。
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(tǒng)在40歲以后就開(kāi)始退化。隨著年齡的增長(zhǎng)，人們坐著的時(shí)間越來(lái)越長(zhǎng)，也開(kāi)始更加依賴視覺(jué)系統(tǒng)。問(wèn)題在于，視覺(jué)系統(tǒng)的反應(yīng)速度不及前庭系統(tǒng)，所以人們就開(kāi)始站不穩(wěn)甚至摔倒。卡倫博士說(shuō)：“于是人們就不再相信自己的平衡感，所以更愿意坐著。并且由于活動(dòng)減少，你實(shí)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.
鍛煉可以強(qiáng)化不同的系統(tǒng)，也會(huì)促使身體努力運(yùn)轉(zhuǎn)從而讓這些系統(tǒng)保持最佳狀態(tài)。專家建議每天以五到10分鐘為一組，鍛煉幾次。
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.
在城市里乘坐公共交通的人盡量不要緊握地鐵車廂里的扶手桿。少用扶手桿會(huì)促使你依靠自身來(lái)保持平衡。芒特西奈醫(yī)院的約翰遜說(shuō)，另一個(gè)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?yàn)槁访娴淖兓瘯?huì)增加肌肉的運(yùn)動(dòng)量。
Other exercises:
其他鍛煉：
-- 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(shuō)，身體直立并將右臂向前平伸，同時(shí)前后擺動(dòng)左腿，反之亦然。這是為了鍛煉協(xié)調(diào)能力。之后試著把眼睛閉上來(lái)減少對(duì)于用視覺(jué)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(xué)(University of Pittsburgh)理療學(xué)副教授珍妮弗・布拉克(Jennifer Brach)說(shuō)，強(qiáng)健臀部肌肉，這是保持平衡感的重要環(huán)節(jié)，這項(xiàng)運(yùn)動(dòng)可在廚房操作臺(tái)邊完成。手扶著操作臺(tái)，同時(shí)單腿站立，另一條腿前伸、側(cè)伸、后伸，再抬腿屈膝，就像列隊(duì)行進(jìn)一樣。這樣能夠使臀部的四組肌群得到運(yùn)動(dòng)：臀部外展肌、臀部?jī)?nèi)收肌、臀部伸肌和屈肌。（這些肌肉也可通過(guò)健身房的臀部伸展器械進(jìn)行鍛煉。）
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.
杰克遜說(shuō)，對(duì)于白領(lǐng)一族，只要連續(xù)從椅子上起立10次就很有效果。先將雙腳分開(kāi)一定距離起立，這會(huì)給身體提供更多支撐，再雙腳并攏起立，兩者交替進(jìn)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(shuō)：“雙腳并攏時(shí)保持平衡要困難得多，所以雙腳距離的變化就是考驗(yàn)?zāi)愕膮f(xié)調(diào)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(shuō)，良好的平衡感也需要“鍛煉神經(jīng)系統(tǒng)。為了訓(xùn)練平衡感，人們應(yīng)該在節(jié)奏感和協(xié)調(diào)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.
她在診所里對(duì)病人做的一項(xiàng)訓(xùn)練是“步伐練習(xí)”。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，重復(fù)做10次。之后將左腳放在右腳前面做相同的動(dòng)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(shuō)，另一種難度更高的版本是左右移動(dòng)，按照左-右-左-右的節(jié)奏，從而讓身體更快地適應(yīng)重心的轉(zhuǎn)換。你也可以向后移動(dòng)，使其更具有挑戰(zhàn)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(shuō)，這種步伐與交誼舞的步伐相似，“讓你思考、調(diào)整身體并把握節(jié)奏”。可以讓人學(xué)會(huì)新的動(dòng)作并增強(qiáng)環(huán)境適應(yīng)能力的運(yùn)動(dòng)──例如網(wǎng)球和體操──似乎更適合訓(xùn)練平衡感，長(zhǎng)跑則不太適合。但布拉克博士也說(shuō)：“沒(méi)有研究確切表明某一項(xiàng)運(yùn)動(dòng)優(yōu)于另一項(xiàng)。”
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.
在客廳或者后花園繞圈走也是不錯(cuò)的鍛煉，因?yàn)檠刂【€行走對(duì)身體更具挑戰(zhàn)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(xué)(Colorado State University)作業(yè)療法學(xué)副教授阿琳・施密德(Arlene Schmid)說(shuō)，心理因素也影響著平衡感的恢復(fù)。對(duì)于因年齡和疾病造成的平衡感下降的人來(lái)說(shuō)，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(xiàng)研究中，施密德博士的團(tuán)隊(duì)對(duì)中風(fēng)康復(fù)患者進(jìn)行了為期八周的瑜伽教學(xué)。在34名患者中，19人經(jīng)伯格氏平衡量表評(píng)估為平衡感受損。在訓(xùn)練過(guò)后，平衡感受損的人數(shù)減為11人。該研究論文于2012年發(fā)表于醫(yī)學(xué)雜志《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(shuō)她認(rèn)為這些患者的成功很大程度上是因?yàn)樗麄儗?duì)自己能夠取得進(jìn)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(shuō)：“我們真的非常努力地讓每個(gè)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(xí)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(shuō)，瑜伽能夠增強(qiáng)人的平衡感，因?yàn)樗鲞M(jìn)了靈活度，同時(shí)瑜伽的各種體式融合了可以強(qiáng)化各種肌群的動(dòng)作，包括臀部的肌肉。但是情感因素才是關(guān)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(shuō)：“人們害怕摔倒就不再活動(dòng)了，而最好的解決辦法就是不要害怕。”
Balance-Boosting Exercises
增強(qiáng)平衡感的練習(xí)
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，并且讓圈子越來(lái)越小，這樣弧度也就越來(lái)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臺(tái)面），另一條腿前伸、側(cè)伸、后伸，再抬腿屈膝，就像列隊(duì)行進(jìn)一樣。這些動(dòng)作能夠使臀部的四組肌群得到運(yùn)動(dòng)，對(duì)于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(xù)起立10次，并且不依靠扶手。雙腳分開(kāi)、并攏交替站立。閉上眼睛來(lái)增加難度。
Put five cones (or other objects) in a straight line and weave between them.
將五個(gè)圓錐形物體（或者其他東西）排成一條直線，并在其間繞行。
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，重復(fù)做10次。之后將左腳放在右腳前面做相同的動(dòng)作。變換形式：左右腳替換，或者向后移動(dòng)，或者閉上眼睛。
