Erika Harold, DPT, works as a physical therapist with the CVA (cerebrovascular accident) acute inpatient rehab team at MossRehab Elkins Park. She is a neurological clinical specialist and certified in using the EksoNR Robotic Exoskeleton in gait rehabilitation

What inspired you to become a physical therapist?

My mom, who is in healthcare, encouraged me to explore different career options when in high school. After volunteering at different physical therapy (PT) clinics, I liked how therapists build a relationship with patients while using movement and exercise to treat injuries. Since I enjoyed working with people and living an active lifestyle, that experience put me on track to pursue a PT career. 

Can you tell me about your education?

I received my undergraduate degree from Elizabethtown College, which had a cooperative three-plus-three program with Thomas Jefferson University. I spent three years at Elizabethtown, then transitioned to Thomas Jefferson, where I earned my doctor of physical therapy degree in three years. When attending Jefferson, I completed clinicals at the University of Maryland Medical Center within their outpatient neuro program and Magee Rehabilitation Hospital in inpatient acute rehab. The experiences got me interested in acute rehab and the neuro field. 

Where do you work in the MossRehab network?

I started my PT career in acute care at the University of Maryland Medical Center. After two years, I wanted to return to the neuro field and applied for the MossRehab Neurologic PT Residency Program. It gave me more exposure to the neuro population while working in acute rehab. After finishing the year-long residency in 2018, I started working full-time at MossRehab on the CVA (cerebrovascular accident) acute inpatient rehab team in Elkins Park. I decided to stay after completing my residency at MossRehab because of the opportunities available both clinically and professionally. MossRehab fosters a great learning environment where I can continue to grow.

Can you tell us about the MossRehab Neurologic PT Residency Program?

During my Neurologic PT Residency, I rotated on the neuro inpatient acute rehab, traumatic brain injury (TBI), spinal cord injury, and stroke units. The residency gave me the necessary clinical hours to take the neurological clinical specialist (NCS) exam, which I passed. While you don’t have to do a residency, it puts you on a fast track to become an NCS.

Who are your patients?

Working as part of the CVA team, I primarily treat patients who had a stroke. I also see those diagnosed with a brain tumor or Parkinson's disease. In addition, I float to the TBI and spinal cord injury units.

What is your role in their rehabilitation?

I think the biggest role that a PT plays in an acute rehab setting is helping patients achieve walking independence. I focus on gross motor movement needed to get around daily and perform tasks such as walking, standing, climbing the stairs, etc. I’ll also help patients learn how to use an assistive device such as a cane or wheelchair. Another part is educating the patient and their family on moving safely when returning home and accepting and finding new ways of living with their new diagnosis.

What is your approach to therapy?

I get to know my patients as individuals, discussing what they did before having a stroke, their hobbies, what they like and don’t like. Hearing their life stories helps me gain a patient’s trust and understand what motivates them. I'm asking patients to do some scary things when they don’t have full control over their bodies. Finding what drives them can make it easier to push them towards meeting a goal.

Do you use robotics in your rehab practices?

Therapeutic robots can complement and enhance physical therapy. Research indicates that two-thirds of individuals after stroke can't walk safely without help or not at all. When I have patients walking during rehab, they might only go a small distance while I significantly support them. Patients also might only be able to stand or walk for a few minutes before fatiguing. Robots can keep patients safely stand for longer periods to improve their endurance and intensify walking to improve outcomes.

Can you provide an example of how you might use technology during therapy?

I became a certified user of the EksoNR Robotic Exoskeleton in June 2021. I use it with patients who have poor postural or trunk control and require the assistance of two to three people to walk safely. Using the EksoNR, they only need me and an aid to walk safely. It also gives patients who might buckle more stability to improve stepping and increase gait speed. The EksoNR allows me to change the level of assistance in each leg. People who had a stroke frequently are stronger on one side. So, I can essentially free the intact limb while the exoskeleton supports the impaired limb.

What are your clinical interests?

High-intensity gait training after a stroke and the benefits of utilizing robots in the sub-acute phases of a stroke interest me. A lot of research is conducted in the PT world on how therapeutic robotics benefit individuals after a stroke in acute rehab. I was a co-author on a recently published paper entitled Implementing Robotic-Assisted Gait Training in Acute Inpatient Stroke Rehabilitation: A Quality Improvement Initiative. It focused on a study identifying the feasibility of using robots to increase the intensity of gait training with dependent patients after a CVA. Results indicated that robotics helped low-level patients that required the support of two to three people to walk safely to take more steps with less assistance that positively affected their overall independence score. 

What inspires you on the job?

My patients’ progress inspires me. They're just resilient to work hard when in difficult situations. It inspires me to work harder in helping them.

Who has had a strong influence on your life?

My parents. They encouraged me to take advantage of opportunities where I can learn and grow. Even if an experience wasn’t successful, I could still learn something and apply it to the next thing on which I was working. Also, my husband helped me through PT school and residency. I honestly don’t think I would have completed them without my husband’s support.

What are your interests outside of work?

I like running, yoga, and indoor cycling classes. I have a two-year-old Springer Spaniel that is full of energy and gets me outside multiple times a day.

What is your favorite place to vacation?

Hawaii. I've been fortunate to go a few times. Generally, I like to be outside on vacation and go hiking or kayaking. 

What is the last book that you read?

Nightingale by Kristen Hanna.

What is your favorite food?

I like anything chocolate and peanut butter.

What is your life motto?

It’s a Bible verse that I remember when I went to Catholic school: Act justly, love tenderly, and walk humbly.

Learn more about MossRehab Physical Therapy.