Originality and interests of the mobile rehabilitation and reintegration Team (EM3R) for patient with brain disease at the university hospital of Strasbourg

Abstract

Established in 2014, the EM3R of the University Institute of Rehabilitation Clemenceau (IURC) of Strasbourg is a team of support and coordination for the patients with cerebral disease. It differs from a mobile 2R team (rehabilitation, readaptation) by its precocity of action and from a traditional 3R mobile team because it does not realize direct rehabilitation care. Its activity is realized with one physician doctor, one occupational therapist and one medical secretary of the IURC. Our activity will be summarized as follow: Specificity: out of a thousand annual evaluations, 95% concern patient with brain lesions, 5% other diseases. Reactivity: 70% of evaluations are realized within 72 hours post-report. Precocity: 30% of evaluations are performed within 72 hours following the advent of the disease. This low figure is due to the fact that the units are slow to call the EM3R. Coordination: If it is necessary to start quickly the treatments combining physiotherapy, occupational therapy and language therapy, they will only be fully effective if they are coordinated. The specialist EM3R physician has the capacities of this coordination and helps to set up a specific rehabilitation project, project discussed weekly with the rehabilitation team of the Stroke Unit, of the intensive care unit and neurosurgery. The EM3R through its knowledge of the rehabilitation and of the social care units, propose in conjunction with these short-stay teams, the most appropriate care pathway: “The right patient at the right place”. The EM3R try to Improve the care by professional training (caregivers, paramedical and medical teams) and by carrying out specific technical acts usually realized later in rehabilitation centers (thermoplastic splints, botulin toxin). Our Strasbourg EM3R does not provide home care and direct rehabilitation care, which distinguishes it from conventional EM2R and EM3R. Nevertheless, our team is an indispensable actor in the quality and the effectiveness of the medical care by dint of the precocity of evaluation, the knowledge of the management of patients with cerebral disease, the coordination of physiotherapy cares, the realization of specific treatment and the knowledge of rehabilitation and social structures.