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Related Experiment Video

Updated: Jul 16, 2025

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers
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Using normalisation process theory for intervention development, implementation and refinement in musculoskeletal and

Hayley Carter1,2, David Beard3, Alison Harvey4

  • 1Physiotherapy Outpatients, Level 3, Florence Nightingale Community Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, DE1 2QY, UK. hayley.carter1@nhs.net.

Implementation Science Communications
|September 18, 2023
PubMed
Summary

Normalisation Process Theory (NPT) aids healthcare intervention implementation. This review confirms NPT/ENPT

Keywords:
Complex interventionsExtended normalisation process theoryMusculoskeletal conditionsNoMADNormalisation process theoryOrthopaedic conditions

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Area of Science:

  • Healthcare Intervention Research
  • Implementation Science
  • Musculoskeletal Health

Background:

  • Normalisation Process Theory (NPT) offers tools for understanding intervention implementation, normalization, and sustainability.
  • Previous reviews focused on NPT in general healthcare interventions.
  • The utility of NPT in orthopaedic and musculoskeletal (MSK) intervention research remains unclear.

Purpose of the Study:

  • To explore the application and utility of Normalisation Process Theory (NPT), including its extension (ENPT), in orthopaedic and musculoskeletal intervention research.

Main Methods:

  • A qualitative systematic review was conducted.
  • Searches were performed in Scopus, Web of Science, and Google Scholar.
  • Data were extracted and analyzed using a framework approach.

Main Results:

  • 14 papers from 12 studies were included.
  • Five findings of high confidence support NPT/ENPT's use in implementing MSK/orthopaedic interventions.
  • NPT/ENPT provides a valuable analytical lens for implementation factors, though its selection and the use of the Normalisation Measure Development instrument have limited evidence.

Conclusions:

  • NPT is useful for supporting intervention implementation in orthopaedic and musculoskeletal conditions.
  • Extended NPT (ENPT) offers benefits for intervention development and refinement.
  • Researchers should clearly justify their use of NPT in methodologies.