長輩走路搖搖晃晃？可能不是腳無力而是「大腦斷線」！復健科醫師提醒：做對這個動作就能找回平衡。 智慧之泉

長輩走路搖搖晃晃？可能不是腳無力，而是「大腦斷線」！復健科醫師提醒：做對這個動作就能找回平衡

一、現象：為什麼長輩走路會「搖晃」？

很多家屬或長輩自己會觀察到，老人家在行走時常常步伐不穩、左右晃動、重心擺盪明顯，甚至會有害怕跌倒的情況。傳統常見的解釋是「腿沒力」或「肌肉退化」，但很多時候，其實問題不在肌力，而是在「大腦 — 傳導 — 協調」這條鏈路出現斷裂或效率降低。

在那支影片中，就提到：可以從手指輕觸牆壁開始練習，若能不依賴觸牆就更好；在單腳站立時，也可以慢慢轉頭以挑戰平衡與穩定度。YouTube

二、背後原理：為什麼說是「大腦斷線」？

1. 行走其實是一個複雜的神經協調過程

行走並不是單純「抬腿－踏步」的動作，它牽涉以下幾個系統必須協同運作：

• 運動控制系統：大腦皮質運動區、基底核、小腦等要發出指令。

• 感覺系統 / 本體覺：身體要知道自己在空間裡的位置（腳在哪、身體傾斜多少）。

• 視覺 / 前庭系統：眼睛與內耳平衡器官提供空間定位與平衡參考。

• 肌肉 / 骨骼 /關節：肌肉需要有足夠張力與反應能力來修正姿勢。

當年紀漸長、血管、白質、神經傳導效率下降或受損時，從大腦發出的平衡與協調指令，在傳導過程中可能變得緩慢或模糊，造成「訊號斷線」或「延遲」。舉例來說，若大腦對於身體微小傾斜的反應慢了，腳就來不及修正，於是就產生搖晃。

許多研究也發現，年齡增長後，步態穩定性（特別是「側向搖晃」）會明顯變差。arXiv

2. 其他可能的干擾因素

除了所謂的「大腦斷線」，還有很多可能讓長輩走路不穩的原因，包括：

• 小腦病變或退化：若小腦受損，協調和平衡能力會受到影響，走路時可能步伐較寬、擺動較大。ntuh.gov.tw+1

• 腦血管性白質病變、中風後遺症：大腦內白質通道受損，使得運動與感覺信號傳導受阻。Yahoo News+2healthnews.com.tw+2

• 神經系統退化疾病：如帕金森氏症，其特徵之一就是步態異常（小碎步、動作啟動困難等）。Wikipedia

• 周邊神經病變、感覺喪失：如果腳或下肢的感覺神經失去敏感度，身體在走路時無法精準感知姿態。Yahoo News+1

• 骨關節或肌肉問題、肌少症：若關節退化、肌力衰弱，也會使得行走穩定性降低。Yahoo News+2healthnews.com.tw+2

• 藥物副作用或血壓調節問題：許多藥物可能引起頭暈、低血壓，進而影響走路的穩定性。Yahoo News+1

因此，在面對長輩走路不穩時，不能簡單歸因為「腿沒力」，這樣可能忽略潛在的神經系統問題。

三、影片中的建議動作：如何練習找回平衡？

那支影片裡有一個核心動作可以練習，目的在「喚醒」大腦與身體之間的連結、挑戰平衡能力：

建議動作：手指輕觸牆壁 → 單腳站立（可搭配轉頭練習） YouTube

具體步驟可參考：

1. 找一面穩固的牆壁站立

2. 手指微微輕觸牆壁以保持平衡，若能在無需接觸的狀態下維持更好

3. 練習單腳站立，每次嘗試維持 20–30 秒（或依能力調整）

4. 當單腳站立穩定後，加入轉頭（左右轉或上下轉）動作，以增加平衡挑戰

   • 轉頭時，內耳平衡系統與視覺系統會被刺激，要求大腦重新整合更多訊號

5. 重複練習，每天做幾次，慢慢增加時間與難度

這樣的動作設計有幾個好處：

• 提高大腦對於微小平衡偏移的敏感度

• 強化神經傳導與協調反應

• 在控制的條件下可以安全地挑戰穩定性

當然，這只是其中一種簡單的訓練方式。要完整改善平衡，建議可以搭配側向步行、單腳站立、螺旋步、障礙繞行等綜合訓練。

四、如何評估與就醫建議

要確認是否真的是「大腦斷線」或神經系統的問題，以下方向可作為參考：

• 多科評估：因為走路不穩可能來自多種原因，建議可讓醫師從神經內科、老年科、復健科、骨科等多面向評估。Yahoo News+1

• 攜帶藥物清單：就診時記得帶著長輩平日所服用的藥物，因為藥物副作用可能是重要線索。Yahoo News+1

• 神經影像／功能檢查：如腦部 MRI／CT、白質病變評估、神經傳導速度檢查等

• 平衡／步態量測：可以做一些標準的平衡與步態評估（例如單腳站立時間、步態變異性、搖晃度量）

• 早期介入復健：神經系統具有可塑性，透過早期復健與訓練，有機會部分恢復或補償功能。Facebook+1

五、日常生活中的建議與注意事項

• 環境安全：避免地面滑、濕、雜物堆積，以減少跌倒風險

• 穿合適鞋子：應避免拖鞋、過軟鞋底，選擇穩定、有抓地力的鞋款

• 漸進挑戰：不要一開始就做過難的動作，應循序漸進

• 持之以恆：平衡能力改善需要時間，如果中斷練習，效果可能消退

• 監控身體狀況：定期做健康檢查、控制慢性疾病（高血壓、糖尿等）以保護神經血管健康

---

Elderly Sway When Walking? It Might Not Be Weak Legs but a “Brain Disconnection”! Rehab Physicians Advise: Do This Move to Regain Balance

1. The Phenomenon: Why Do Elders “Sway” When They Walk?

You or your family may notice that seniors often have unsteady gait, swaying side to side, or apparent difficulty maintaining balance. The traditional assumption is “weak legs” or muscular decline. But frequently, the root issue lies not in muscle strength, but in a breakdown in the “brain → transmission → coordination” pathway.

In the referenced video, one recommendation is to start by lightly touching a wall with a finger—if one can perform it without touching all the better. When doing single-leg standing, gradually turning the head challenges balance and stability. YouTube

2. The Underlying Mechanism: Why Call It a “Brain Disconnection”?

1. Walking Is a Complex Neural Coordination Task

Walking isn’t just lifting and placing legs; it involves multiple systems working in concert:

• Motor control system: The motor cortex, basal ganglia, cerebellum must issue precise commands.

• Sensory system / proprioception: The body must sense its position (where are my feet? how much tilt is there?).

• Visual / vestibular systems: Eyes and inner ear balance organs provide spatial reference and orientation.

• Musculoskeletal system: Muscles, joints, and tendons must respond with appropriate tension and timing.

As one ages, vascular issues, white matter degeneration, or slower nerve conduction can impair the chain of signals traveling from the brain to muscles. The result: “signal disconnection” or delays. For instance, if the brain’s command to correct for a slight lean is delayed, the feet may not adjust in time, causing swaying.

Research shows that as age increases, gait stability (especially medial–lateral sway) degrades notably. arXiv

2. Other Contributing Factors

Beyond “brain disconnection,” many other factors can compromise walking stability:

• Cerebellar disease or degeneration: Damage to the cerebellum impairs coordination; gait may become wide-based or erratic. ntuh.gov.tw+1

• Cerebrovascular white matter changes, post-stroke damage: Disruption in brain pathways reduces signal conduction. Yahoo News+2healthnews.com.tw+2

• Neurodegenerative disorders: Conditions like Parkinson’s disease show gait abnormalities such as shuffling steps or initiation difficulty. Wikipedia

• Peripheral neuropathy / sensory loss: If lower limb sensation is muted, the body cannot accurately sense posture. Yahoo News+1

• Musculoskeletal / joint / muscle issues / sarcopenia: If joints are stiff or muscles weak, fine corrections become harder. Yahoo News+2healthnews.com.tw+2

• Medication side effects / blood pressure dysregulation: Many medications can cause dizziness or hypotension, affecting gait stability. Yahoo News+1

Hence, when elders walk unsteadily, it’s overly simplistic to blame “weak legs.” One might miss key neurologic causes.

3. The Suggested Move from the Video: Training to Reconnect and Rebalance

The video proposes a core exercise aimed at activating the brain–body connection and challenging balance:

Suggested move: lightly touch the wall with a finger → single-leg standing (with optional head turns) YouTube

Steps:

1. Stand near a sturdy wall.

2. Gently touch the wall with a finger to assist with balance; if able, try no contact.

3. Practice single‐leg standing, holding for ~20–30 seconds (or adjust based on ability).

4. Once stable, add head rotations (turn left–right or up–down)—this challenges vestibular, visual, and proprioceptive integration.

   • As the head moves, the balance system must adjust dynamically.

5. Repeat multiple times daily, gradually increasing duration and challenge.

Benefits:

• Enhances the brain’s sensitivity to micro-imbalances

• Strengthens neural signaling and corrective responses

• Allows a safe way to stress balance in controlled conditions

This is just one simple training method. For more comprehensive balance improvement, it can be paired with lateral stepping, balance walking, single‐leg holds, obstacle courses, etc.

4. Evaluation & Medical Recommendations

To confirm whether the “brain disconnection” or a neurologic cause is in play, consider the following:

• Multidisciplinary evaluation: Because unsteady gait may arise from many sources, have doctors in neurology, geriatrics, rehab, orthopedics assess. Yahoo News+1

• Bring medication list: Bring all current medications when visiting doctors—side effects may hold clues. Yahoo News+1

• Neuroimaging / functional tests: Brain MRI/CT, white matter lesion evaluation, nerve conduction studies

• Balance / gait measurement: Standard tests (single-leg standing time, gait variability, sway amplitude)

• Early rehabilitation intervention: The nervous system retains plasticity; early rehab and training may partially restore or compensate functions. Facebook+1

5. Daily Life Tips & Precautions

• Ensure environmental safety: Avoid slippery or cluttered floors to reduce fall risk

• Wear proper footwear: Avoid loose, soft soles—choose stable shoes with grip

• Progress gradually: Don’t start with overly difficult tasks—build slowly

• Be consistent: Balance improvement takes time; interrupting training may reduce gains

• Monitor overall health: Regular checkups, control chronic diseases (e.g. hypertension, diabetes) to preserve vascular/neural health

---

Hashtags / 標籤

（中文）
#長輩健康 #平衡訓練 #復健運動 #老年行走 #神經協調 #大腦健康

（English）
#ElderlyBalance #RehabExercise #NeurologicalGait #BrainConnection #FallPrevention #SeniorMobility

長輩走路搖搖晃晃？可能不是腳無力而是「大腦斷線」！復健科醫師提醒：做對這個動作就能找回平衡。

智慧之泉