Using normalisation process theory for intervention development, implementation and refinement in musculoskeletal and...

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.