Royal Philips and the World Stroke Organization (WSO) recently announced they are partnering to advocate for better care for patients who experience cerebrovascular accidents (CVA), also known as stroke.

Philips’s paper, Time for a Revolution in Stroke Care, noted that CVA “is a leading cause of disability and the second-leading cause of death worldwide. The direct and indirect costs are conservatively estimated to more than double over the next 25 years.”

The paper notes that the technology to significantly reduce the damaging impact of CVA already exists. For example, a mechanical thrombectomy — a minimally invasive procedure to remove blood clots that cause or could cause strokes — “has been proven to be both effective at achieving better clinical outcomes and highly cost effective for patients with acute ischemic stroke.” Clinical trials have shown that mechanical thrombectomy “is a highly effective treatment for the most severe and debilitating strokes, preventing — and even reversing their impact.”

Unfortunately, in 2019 “Fewer than 5% of eligible patients received thrombectomy globally,” the paper said.

So — if we have the technology, but patients have difficulty accessing it … what have we gained?

Universal access to the best mobility solutions

Now, take that idea and apply it to seating, wheeled mobility, and patients with CVA.

Although Philips and the WSO noted increasing numbers of first-time CVA patients younger than 55, the Centers for Disease Control (CDC) noted in a 2020-2022 study that stroke prevalence was highest among adults older than 65. Stroke has been and still largely is a “senior” disease condition.

In talking over the years with seating clinicians, I’ve heard over and over that too many senior stroke patients are routinely steered toward dependent mobility — toward wheelchairs that are not ultralightweights designed for optimal self propulsion and high performance.

Instead, seniors are more likely to receive standard or lightweight manual wheelchairs in the K0001-K0004 categories — chairs that are heavier, less adjustable or customizable to the client, less fully featured. Chairs that are less likely to inspire independent mobility and therefore engagement.

Are younger stroke patients more likely to be steered toward ultralightweight wheelchairs because they still have most of their lives in front of them: careers to forge, families to raise? Are assumptions made, even subconsciously, that younger clients still have their most active years ahead of them, whereas seniors are thought to have fewer adventures left?

Would a 22-year-old stroke patient and an 82-year-old stroke patient at similar functional levels and abilities be considered for the same types of seating and wheeled mobility?

Thankfully, many seating clinicians have told me yes — that client age is not the most important factor, and that they strive for the best possible outcomes for every client. But I wonder about stroke patients who don’t have access to seating clinics and seating specialists.

I hope that revolutionary stroke care and access to the best-available technology includes seating and wheeled mobility. I hope that seniors affected by CVA won’t be so automatically bundled into generic standard or lightweight wheelchairs with the assumption that those patients mostly just want to sit and stare out the window at the world.

I hope that any CVA revolution includes the opportunity for all stroke patients, including seniors, to propel — or drive — themselves right out the door and into the wide world, if that’s where they want to be.