首頁(yè) 資訊不能久坐，我站著還不行么？

不能久坐，我站著還不行么？

來(lái)源：泰然健康網(wǎng) 時(shí)間：2024年12月04日 12:28

在辦公室或教室坐一整天，難免渾身僵硬，肩頸腰背酸痛。即使下班或下課后拼命運(yùn)動(dòng)，也很難抵消久坐帶來(lái)的不舒服。

除了難受，長(zhǎng)時(shí)間的靜坐還會(huì)使人容易長(zhǎng)胖，患2型糖尿病、腫瘤及心血管疾病的風(fēng)險(xiǎn)也升高[1]。知道久坐有害后，越來(lái)越多的人開(kāi)始嘗試別的姿勢(shì)，甚至隨之出現(xiàn)了專(zhuān)供站立辦公的設(shè)備，比如可升降桌子、筆記本支架、可調(diào)高度的屏幕支架等。

站立辦公設(shè)備丨參考文獻(xiàn)[2]

用了這些設(shè)備，人們可以做到每天坐著的時(shí)間平均縮短1.3小時(shí)，站立時(shí)間增加1.4小時(shí)[1]?？此瞥尚э@著，但別忘了減少久坐只是手段，大家改變姿勢(shì)目的是減少久坐帶來(lái)的健康危害、緩解身體的僵硬酸痛、預(yù)防打瞌睡或通過(guò)增加消耗來(lái)減肥。由坐到站，能不能實(shí)現(xiàn)這些目標(biāo)？

站得那么累，怎么還算“久坐”

想知道站立是否有利，還得先看久坐為什么有害。實(shí)際上，久坐行為的危害不在于“坐”，而在于很低的能量消耗。

其實(shí)不管你是坐、靠、躺還是站，無(wú)論在工作、玩游戲或者坐車(chē)，只要清醒狀態(tài)下能量消耗低于靜坐的1.5~2倍，都屬于久坐行為[1]。

對(duì)于多數(shù)人來(lái)說(shuō)，僅僅站起來(lái)不能使能量消耗超出久坐范圍，也不能增加運(yùn)動(dòng)量[3, 4]。既然脫離不了久坐行為，站立的好處也存在疑問(wèn)。

圖丨圖蟲(chóng)創(chuàng)意

腰痛可能有效，其他不一定

為了健康站起來(lái)的人可能對(duì)下面的消息很失望：多數(shù)研究中，堅(jiān)持間斷站立辦公數(shù)月時(shí)間，并不能明顯改善健康人的血壓、血糖及血脂水平，僅肥胖者的血糖水平可能有所好轉(zhuǎn)[1, 5]。

有人聽(tīng)了會(huì)說(shuō)“我站來(lái)又不是為了防病，只是因?yàn)橐恢弊y受”。對(duì)于緩解身體僵硬酸痛，坐站交替可能優(yōu)于久坐，特別是對(duì)于慢性腰痛的人[6, 7]。絕大多數(shù)人會(huì)都在一生中某個(gè)階段經(jīng)歷腰痛，長(zhǎng)時(shí)間靜坐可能加重癥狀[8]。在久坐辦公間歇適當(dāng)站立，會(huì)使部分人的腰痛癥狀明顯減輕。

雖然站立可能緩解腰痛，但對(duì)肩頸、上肢不適及酸痛的作用有限[4, 9-11]，還要親身嘗試才能知道對(duì)個(gè)人是否有效。對(duì)于下肢，站立姿勢(shì)反而比坐位更容易引起酸痛。

站立緩解酸痛的效果不一致，也與大家姿勢(shì)不同有關(guān)。頸部、軀干及下肢正確排列才能減輕疲勞，如果過(guò)度低頭、彎腰或始終將重心放在某一條腿上反而不舒服。

圖丨圖蟲(chóng)創(chuàng)意

站立使我清醒？

除了身體僵硬酸痛，上班時(shí)的困倦也讓人難以抵抗。很多人看到支架上標(biāo)注的“提高效率，活力加倍”，而期望站立如咖啡一般提神醒腦。

其實(shí)多數(shù)研究中，人們坐著與站著時(shí)的困倦程度及情緒并沒(méi)有明顯區(qū)別[12, 13]。少數(shù)人站立后感覺(jué)更有活力并且心情更好，另一些人站起來(lái)反而比持續(xù)坐著更疲勞[14, 15]。

既然不能提神醒腦，對(duì)于多數(shù)人來(lái)說(shuō)，站與坐時(shí)的工作效率也沒(méi)有明顯區(qū)別[16, 17]。當(dāng)然了，上課犯困時(shí)被拎起來(lái)罰站聽(tīng)講，是個(gè)例外。

圖丨圖蟲(chóng)創(chuàng)意

減肥，還是別指望了

除了提高工作效率，站立辦公設(shè)備的宣傳里還常有“消除贅肉”。確實(shí)一般人站著比坐著消耗能量稍多，但兩者差異并不大[18]。相對(duì)于坐著，站立1小時(shí)能量消耗只多出4.2~10千卡[1]，即使每天站立累計(jì)4小時(shí)，多消耗的熱量還抵不上兩小塊巧克力。

另外還有少數(shù)人非常擅長(zhǎng)站，靜止站立時(shí)能量消耗甚至低于坐著。因此，嘗試用站代替坐來(lái)減肥的研究，都沒(méi)有得出站立瘦身的結(jié)果[19-21]。

站久了還不如坐著

站著的獲益不是很確定，但久站的危害人們?cè)缇腕w會(huì)到了。早年間，很多工人都需要整日站著工作，不能坐下或來(lái)回走動(dòng)。他們不僅飽受腰痛、腳痛、下肢靜脈曲張、腿腳水腫的折磨，女性還會(huì)因長(zhǎng)時(shí)間站立增加早產(chǎn)及流產(chǎn)的風(fēng)險(xiǎn)[1]。

下肢靜脈曲張丨圖蟲(chóng)創(chuàng)意

對(duì)于多數(shù)人，舒適的持續(xù)站立時(shí)間不超過(guò)15~30分鐘[22, 23]。如果為了減輕背部不適而站立，每次15分鐘就足夠了，持續(xù)站立時(shí)間過(guò)長(zhǎng)反而難受[24]。

當(dāng)靜止站立達(dá)到30分鐘時(shí)，小腿及足部的血流增多，疲勞、不適及疼痛的感覺(jué)開(kāi)始出現(xiàn)[25]。已經(jīng)存在外周血管疾病的人，應(yīng)盡量避免連續(xù)站立30分鐘以上。如果工作需要連續(xù)站立2小時(shí)以上，可利用壓縮襪、地墊、鞋墊及坐站兩用凳子來(lái)緩解疲勞[25]。

多換姿勢(shì)，多活動(dòng)

無(wú)論坐著還是站著，長(zhǎng)時(shí)間的靜態(tài)姿勢(shì)都對(duì)健康不利并且導(dǎo)致身體酸痛不適。

想要改善身體僵硬及肌肉疲勞，關(guān)鍵在于經(jīng)常變換姿勢(shì)，而不是長(zhǎng)時(shí)間的持續(xù)站立[1]。對(duì)于減輕體重或久坐健康危害，進(jìn)行比站立強(qiáng)度更大的活動(dòng)，才有肯定的效果。

常年久坐不動(dòng)的人，可以從工作中坐站交替及輕度體力活動(dòng)開(kāi)始，逐漸增加時(shí)間及活動(dòng)強(qiáng)度。添置桌子或支架是途徑之一，多走動(dòng)比靜靜站著更為有效[26]。

在不打擾別人的前提下，可以多活動(dòng)丨giphy

參考文獻(xiàn)

[1] Chambers AJ, Robertson MM, Baker NA. The effect of sit-stand desks on office worker behavioral and health outcomes: A scoping review. Appl Ergon. 2019;78:37-53.

[2] Pronk NP, Katz AS, Lowry M, et al. Reducing occupational sitting time and improving worker health: the Take-a-Stand Project, 2011. Prev Chronic Dis. 2012;9:E154.

[3] Burns J, Forde C, Dockrell S. Energy Expenditure of Standing Compared to Sitting While Conducting Office Tasks. Hum Factors. 2017;59(7):1078-1087.

[4] Ee J, Parry S, Oliveira BI, et al. Does a Classroom Standing Desk Intervention Modify Standing and Sitting Behaviour and Musculoskeletal Symptoms during School Time and Physical Activity during Waking Time? Int J Environ Res Public Health. 2018;15(8).

[5] David Rempel. Do Sit-Stand Workstations Improve Cardiovascular Health? J Occup Environ Med. 2018;60(7):e319-e320.

[6] Johnston V, Gane EM, Brown W, et al. Feasibility and impact of sit-stand workstations with and without exercise in office workers at risk of low back pain: A pilot comparative effectiveness trial. Appl Ergon. 2019;76:82-89.

[7] Agarwal S, Steinmaus C, Harris-Adamson C. Sit-stand workstations and impact on low back discomfort: a systematic review and meta-analysis. Ergonomics. 2018;61(4):538-552.

[8] Sribastav SS, Long J, He P, et al. Risk Factors Associated with Pain Severity in Patients with Non-specific Low Back Pain in Southern China. Asian Spine J. 2018;12(3):533-543.

[9] Hoe VC, Urquhart DM, Kelsall HL, et al. Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers. Cochrane Database Syst Rev. 2018;10:CD008570.

[10] Brakenridge CL, Chong YY, Winkler EAH, et al. Evaluating Short-Term Musculoskeletal Pain Changes in Desk-Based Workers Receiving a Workplace Sitting-Reduction Intervention. Int J Environ Res Public Health. 2018;15(9).

[11] E F Graves L, C Murphy R, Shepherd SO, et al. Evaluation of sit-stand workstations in an office setting: a randomised controlled trial. BMC Public Health. 2015;15:1145.

[12] Schwartz B, Kapellusch JM, Schrempf A, et al. Effect of alternating postures on cognitive performance for healthy people performing sedentary work. Ergonomics. 2018;61(6):778-795.

[13] Schwartz B, Kapellusch JM, Baca A, et al. Medium-term effects of a two-desk sit/stand workstation on cognitive performance and workload for healthy people performing sedentary work: a secondary analysis of a randomised controlled trial. Ergonomics. 2019;62(6):794-810.

[14] Renaud LR, Huysmans MA, van der Ploeg HP, et al. Long-Term Access to Sit-Stand Workstations in a Large Office Population: User Profiles Reveal Differences in Sitting Time and Perceptions. Int J Environ Res Public Health. 2018;15(9).

[15] Dewitt S, Hall J, Smith L, et al. Office workers' experiences of attempts to reduce sitting-time: an exploratory, mixed-methods uncontrolled intervention pilot study. BMC Public Health. 2019;19(1):819.

[16] Ojo SO, Bailey DP, Chater AM, et al. The Impact of Active Workstations on Workplace Productivity and Performance: A Systematic Review. Int J Environ Res Public Health. 2018;15(3).

[17] Finch LE, Tomiyama AJ, Ward A. Taking a Stand: The Effects of Standing Desks on Task Performance and Engagement. Int J Environ Res Public Health. 2017;14(8).

[18] Mantzari E, Galloway C, Wijndaele K, et al. Impact of sit-stand desks at work on energy expenditure, sitting time and cardio-metabolic risk factors: Multiphase feasibility study with randomised controlled component. Prev Med Rep. 2018;13:64-72.

[19] Alkhajah TA, Reeves MM, Eakin EG, et al. Sit-stand workstations: a pilot intervention to reduce office sitting time. Am J Prev Med. 2012;43(3):298-303.

[20] Healy GN, Winkler EAH, Eakin EG, et al. A Cluster RCT to Reduce Workers' Sitting Time: Impact on Cardiometabolic Biomarkers. Med Sci Sports Exerc. 2017;49(10):2032-2039.

[21] MacEwen BT, Saunders TJ, MacDonald DJ, et al. Sit-Stand Desks To Reduce Workplace Sitting Time In Office Workers With Abdominal Obesity: A Randomized Controlled Trial. J Phys Act Health. 2017;14(9):710-715.

[22] Antle DM, Cormier L, Findlay M, et al. Lower limb blood flow and mean arterial pressure during standing and seated work: Implications for workplace posture recommendations. Prev Med Rep. 2018;10:117-122.

[23] Pei H, Yu S, Babski-Reeves K, et al. Quantification of lower extremity physical exposures in various combinations of sit/stand time duration associated with sit-stand workstation. Med Pr. 2017;68(3):315-327.

[24] Lin MY, Barbir A, Dennerlein JT. Evaluating biomechanics of user-selected sitting and standing computer workstation. Appl Ergon. 2017;65:382-388.

[25] Waters TR, Dick RB. Evidence of health risks associated with prolonged standing at work and intervention effectiveness. Rehabil Nurs. 2015;40(3):148-165.

[26] Buckley JP, Hedge A, Yates T, et al. The sedentary office: an expert statement on the growing case for change towards better health and productivity. Br J Sports Med. 2015;49(21):1357-1362.

作者：代天醫(yī)

編輯：odette