一位中風後左側無力的病人正在學習使用手杖。護理師觀察到下列哪項行為，表示病人正確使用了手杖？
A client with left-sided weakness following a stroke is learning to use a cane. Which observation by the nurse indicates the client is using the cane correctly?
- AThe client keeps the cane 12 inches in front of the feet at all times.病人始終將手杖保持在腳尖前方12英吋處。
- BThe client moves the cane and the right leg forward at the same time.病人同時向前移動手杖和右腿。
- CThe client holds the cane in the left hand.病人將手杖握在左手。
- DThe client holds the cane in the right hand and moves the cane with the left leg.✓ 正解病人將手杖握在右手，並與左腿一起移動手杖。
手杖使用的核心原則是「健側手持杖」（COAL: Cane Opposite Affected Leg）。這題考察的是基本輔具安全。正確動作是將手杖握在強壯的一側（右側），並在邁出患側肢體（左側）時同時移動手杖。這樣做可以將體重從患側轉移到手杖上，增加支撐面積並減輕患肢負擔。為什麼其他不對？C 選項會導致重心不穩；B 選項將強壯肢體與手杖同時移動，無法發揮輔助患側的功能。護理師在衛教時應強調手杖的高度應與大轉子（Greater trochanter）齊平，且手肘微彎約 15-30 度，這才是最符合人體工學的姿勢。安全永遠是第一考量，若病人步態不穩，應優先使用助行器而非手杖。
The core principle of cane use is 'cane in the hand opposite the affected leg' (COAL: Cane Opposite Affected Leg). This item tests basic assistive-device safety. The correct technique is to hold the cane on the strong side (the right side) and advance the cane at the same time as the affected limb (left side). Doing so shifts weight from the affected side onto the cane, increasing the base of support and reducing the load on the affected limb. Why the others are wrong? Option C would destabilize the center of gravity; option B moves the strong leg and the cane together, failing to provide assistance to the affected side. When teaching, the nurse should emphasize that the cane height should be even with the greater trochanter and that the elbow should be slightly flexed about 15-30 degrees, which is the most ergonomically correct posture. Safety is always the first consideration; if the client's gait is unstable, a walker should be used preferentially rather than a cane.
在美國，物理治療師（PT）通常負責初始評估與選定輔具，護理師負責日常步行強化；在台灣，病房護理師常需直接教導病人基本步態，且對於輔具高度調整，台灣臨床較常使用「手腕橫紋」作為參考點，與美國「大轉子」標準略有不同但原理相似。