不能久坐,我站着还不行么?
在办公室或教室坐一整天,难免浑身僵硬,肩颈腰背酸痛。即使下班或下课后拼命运动,也很难抵消久坐带来的不舒服。
除了难受,长时间的静坐还会使人容易长胖,患2型糖尿病、肿瘤及心血管疾病的风险也升高[1]。知道久坐有害后,越来越多的人开始尝试别的姿势,甚至随之出现了专供站立办公的设备,比如可升降桌子、笔记本支架、可调高度的屏幕支架等。
站立办公设备丨参考文献[2]
用了这些设备,人们可以做到每天坐着的时间平均缩短1.3小时,站立时间增加1.4小时[1]。看似成效显著,但别忘了减少久坐只是手段,大家改变姿势目的是减少久坐带来的健康危害、缓解身体的僵硬酸痛、预防打瞌睡或通过增加消耗来减肥。由坐到站,能不能实现这些目标?
站得那么累,怎么还算“久坐”
想知道站立是否有利,还得先看久坐为什么有害。实际上,久坐行为的危害不在于“坐”,而在于很低的能量消耗。
其实不管你是坐、靠、躺还是站,无论在工作、玩游戏或者坐车,只要清醒状态下能量消耗低于静坐的1.5~2倍,都属于久坐行为[1]。
对于多数人来说,仅仅站起来不能使能量消耗超出久坐范围,也不能增加运动量[3, 4]。既然脱离不了久坐行为,站立的好处也存在疑问。
图丨图虫创意
腰痛可能有效,其他不一定
为了健康站起来的人可能对下面的消息很失望:多数研究中,坚持间断站立办公数月时间,并不能明显改善健康人的血压、血糖及血脂水平,仅肥胖者的血糖水平可能有所好转[1, 5]。
有人听了会说“我站来又不是为了防病,只是因为一直坐着太难受”。对于缓解身体僵硬酸痛,坐站交替可能优于久坐,特别是对于慢性腰痛的人[6, 7]。绝大多数人会都在一生中某个阶段经历腰痛,长时间静坐可能加重症状[8]。在久坐办公间歇适当站立,会使部分人的腰痛症状明显减轻。
虽然站立可能缓解腰痛,但对肩颈、上肢不适及酸痛的作用有限[4, 9-11],还要亲身尝试才能知道对个人是否有效。对于下肢,站立姿势反而比坐位更容易引起酸痛。
站立缓解酸痛的效果不一致,也与大家姿势不同有关。颈部、躯干及下肢正确排列才能减轻疲劳,如果过度低头、弯腰或始终将重心放在某一条腿上反而不舒服。
图丨图虫创意
站立使我清醒?
除了身体僵硬酸痛,上班时的困倦也让人难以抵抗。很多人看到支架上标注的“提高效率,活力加倍”,而期望站立如咖啡一般提神醒脑。
其实多数研究中,人们坐着与站着时的困倦程度及情绪并没有明显区别[12, 13]。少数人站立后感觉更有活力并且心情更好,另一些人站起来反而比持续坐着更疲劳[14, 15]。
既然不能提神醒脑,对于多数人来说,站与坐时的工作效率也没有明显区别[16, 17]。当然了,上课犯困时被拎起来罚站听讲,是个例外。
图丨图虫创意
减肥,还是别指望了
除了提高工作效率,站立办公设备的宣传里还常有“消除赘肉”。确实一般人站着比坐着消耗能量稍多,但两者差异并不大[18]。相对于坐着,站立1小时能量消耗只多出4.2~10千卡[1],即使每天站立累计4小时,多消耗的热量还抵不上两小块巧克力。
另外还有少数人非常擅长站,静止站立时能量消耗甚至低于坐着。因此,尝试用站代替坐来减肥的研究,都没有得出站立瘦身的结果[19-21]。
站久了还不如坐着
站着的获益不是很确定,但久站的危害人们早就体会到了。早年间,很多工人都需要整日站着工作,不能坐下或来回走动。他们不仅饱受腰痛、脚痛、下肢静脉曲张、腿脚水肿的折磨,女性还会因长时间站立增加早产及流产的风险[1]。
下肢静脉曲张丨图虫创意
对于多数人,舒适的持续站立时间不超过15~30分钟[22, 23]。如果为了减轻背部不适而站立,每次15分钟就足够了,持续站立时间过长反而难受[24]。
当静止站立达到30分钟时,小腿及足部的血流增多,疲劳、不适及疼痛的感觉开始出现[25]。已经存在外周血管疾病的人,应尽量避免连续站立30分钟以上。如果工作需要连续站立2小时以上,可利用压缩袜、地垫、鞋垫及坐站两用凳子来缓解疲劳[25]。
多换姿势,多活动
无论坐着还是站着,长时间的静态姿势都对健康不利并且导致身体酸痛不适。
想要改善身体僵硬及肌肉疲劳,关键在于经常变换姿势,而不是长时间的持续站立[1]。对于减轻体重或久坐健康危害,进行比站立强度更大的活动,才有肯定的效果。
常年久坐不动的人,可以从工作中坐站交替及轻度体力活动开始,逐渐增加时间及活动强度。添置桌子或支架是途径之一,多走动比静静站着更为有效[26]。
在不打扰别人的前提下,可以多活动丨giphy
参考文献
[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:代天医
编辑:odette
本文来自果壳,未经授权不得转载.
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