What is Neuro-IFRAH®?

Neuro-Integrative Functional Rehabilitation And Habilitation (Neuro-IFRAH®) is an approach originated by Waleed Al-Oboudi, MOT, OTR/L. Mr. Al-Oboudi is known nationally and internationally for his concepts and clinical skills.

The unique name of the approach was originated by the author to give an overall idea to the reader regarding the scope of this approach. The word Neuro- was selected because this approach is intended for patients who are affected by lesions at the level of the brain stem and above. The word Integrative was selected to describe that this approach is integrative on all levels. It is integrative of all systems of the person as well as all information past and present. It is integrative of all internal as well as external variables and combinations and products of these variables affecting patient response, normal or otherwise. It is integrative and inclusive of fields of study as well as bodies of information. It is integrative in terms of variables related to therapists, the rehabilitation team, rehabilitation programs, facilities, home, community, and other environmental variables…It is integrative at all these levels and much more. Any variable that has an affect on the patient needs to be considered. The word Functional means meets intended purpose or need, thus the word functional was selected because this approach is functional. All aspects of rehabilitation and habilitation are individualized to meet the patients intended purpose or need. The words Rehabilitation and Habilitation were selected because this is what we do in therapy. It encompasses many aspects of therapy, thus there is no reason to find other words. One aspect of rehabilitation is to restore to the fullest physical, mental, social, vocational, economic status thus rehabilitation is not limited. However, our patients are not only re-acquiring skills they are learning new ones as well. Thus Habilitation occurs throughout alongside with rehabilitation.

The powerful words used in the name of the approach gives a small glimpse of the wide scope of this truly dynamic, highly individualized, whole person, functional, inclusive, and visionary approach.

PATIENT EDUCATION: THE POWER TO CHOOSE WHERE
AND WITH WHOM YOU ENTRUST YOUR REHABILITATION

Recent professional journals are supporting therapy programs that increase
hypertonicity and compensatory strategies, and avoid the restoration of normal
movement altogether. NEURO-IFRAH® therapists will never turn their backs on helping patients realize their potential for normal movement

It is the NEURO-IFRAH® Organization’s belief that one of the primary purposes of rehabilitation for patients affected by a stroke or brain injury is to help restore normal movement. The NEURO-IFRAH® Organization is comprised of clinicians skilled in restoration. We care deeply about what patients want and we have developed the skills to return them back to life with the fullest extent of normal movement to which they are capable. It is deeply concerning that articles appearing in professional journals have recently declared it unnecessary to work on normal movement, saying: “. . . facilitation of normal movement in an effort to achieve optimal recovery has shown to be unnecessary” (Scheets, Patricia L., et. al. “President’s Perspective: Moving Forward.” Journal of Neurologic Physical Therapy, vol. 45, January 2021, pp. 46-48). There is also the equally concerning statement that, “efforts to reduce spasticity do not improve volitional movement” (Scheets et al. p. 47).

We vehemently disagree with these statements and others like them, which are used as an excuse to ignore the massive side effects of programs being sold as “moving forward” in rehabilitation, when what they are is moving backward in skill, knowledge, and outcome. The stance that hypertonicity has no effect on movement because there is no research saying it does, is simply not a sound or reasonable argument. With such a stance, it becomes unsurprising that the conclusion drawn would be to not work on normal movement because it has become unachievable with such abnormal muscle activity. The fact that these same professional journals claim to have other strategies for achieving optimal recovery without offering self-evident results to support such claims, is yet another point of concern.

What continues to become increasingly self-evident to us is the emergence of massive compensatory strategies. These strategies claim to restore a patient’s ability to walk, and yet they leave those same patients with impairments that are difficult to reverse. Patients arrive to our NEURO-IFRAH® Clinics with hypertonicity, notably in the arms and feet. As a result, these patients suffer, and our skilled therapists must work hard to undo the side effects of abnormal muscle activity that ends up limiting the patient’s options and potential for recovery of more normal movement and control. It is important that patients are not subjected to strategies that increase massive hypertonicity, and are referred to us earlier. The less we have to un-do, the more efficiently patients can find themselves resuming and assuming life roles.

Self-evident and outcome-oriented results are at the heart of NEURO-IFRAH®. Results for us are not merely confined to paper, but rather exemplified in patients who get to live their day-to-day lives with the results. We have decades of experience and overwhelming evidence on video documentation that clearly demonstrates why NEURO-IFRAH® is superior and unmatched in the rehabilitation of patients affected by a stroke or brain injury. We also understand that neurological challenges in rehabilitation require high levels of skill. We understand why rehabilitation of the upper extremity, lower extremity, trunk, head/neck control, facial expressions, oral motor control, total hand and foot function, as well as any movement throughout the body or any functional activity—including all function in upright postures—is challenging to those who do not have our knowledge and experience. We understand why those without our knowledge and experience might therefore want to give up. But the NEURO-IFRAH® Organization completely disagrees with the suggestion of giving up, or the excuses used as a means of giving up.

The patient ultimately has the power to choose where and with whom they entrust their rehabilitation process. Patient education is critical to helping patients avoid activities that sacrifice their potential to recover more normal movement and function. Our therapists will never turn their backs on patients and we recommend that other therapists or practitioners who give up on the rehabilitation of the upper extremity, or any other part or function, refer their patient to us. The NEURO-IFRAH® APPROACH is a whole person approach. We are here and ready to fill the gap.

Clinical Group with input from Patients

IMPORTANT NOTICE REGARDING MISLEADING ADVERTISING

The NEURO-IFRAH Organization has always sought to inform the consumer that we endorse only the NEURO-IFRAH Center, NEURO-IFRAH CLINICS, and NEURO-IFRAH CLINICS BY WALEED. Within this endorsement an important distinction must also be made: The NEURO-IFRAH Organization endorses only the levels of training that have the designation “Clinical” in the title on our certificates. 

Over the years, thousands of therapists have taken and continue to take courses that represent less than 1% of the very basic information of the approach. Attendees of these courses may receive certificates due to meeting attendance requirements, but concepts introduced in these courses represent less than 1% of the approach. Given that the basic course is non-clinical, course certificates should not be used to indicate a level of skill. 

Regarding what it means to be a regular NEURO-IFRAH Instructor: 

NEURO-IFRAH Instructor Training is a training to teach very basic courses which comprise less than 1% of the approach. The trained instructors follow specific transcripts to ensure consistency; no clinical skills are implied. The vast majority of therapists who have completed Instructor Training took this course for networking and for promotions to director/supervisory roles; they did not complete or were not offered the clinical track. Very few instructors teach, as teaching the material requires recall of this basic information on the transcript, and being consistent. 

It should be noted that the NEURO-IFRAH Organization has disassociated from inactive instructors. Only active instructors are listed on the Neuro-IFRAH instructor website, though this listing does not imply clinical skills. NEURO-IFRAH Instructor Clinical, as well as all the certifications that include the word “Clinical” in the service mark, imply specific endorsed clinical skills. No other basic service marks imply ongoing endorsed clinical skills. The NEURO-IFRAH Organization also only endorses and recommends the NEURO-IFRAH Center, NEURO-IFRAH CLINICS, and NEURO-IFRAH CLINICS BY WALEED that are listed on our homepage: https://www.neuro-ifrahclinicsbywaleed.com/

The NEURO-IFRAH approach is a hands on approach and does not endorse any tele-therapy, biotech fads, and high compensation gait programs that do not work on restoring normal movement, do not address deficits in the patient’s trunk, and do not reduce and prevent the abnormal muscle activity in the form of hypertonicity. The NEURO-IFRAH approach restores control while following rehabilitation principles rooted in restoration and not compensation. It is the only approach that is noted for its self-evident results as being superior and unmatched. Thus, it is unsurprising that many therapists who took very basic, non-clinical courses try to claim association or an endorsed level of skill. Consumer discernment regarding misleading advertisement is therefore critical.