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Background: Infants born very preterm are at risk for motor impairments, highlighting the need for early interventions. The Norwegian Physical therapy study in Preterm Infants (NOPPI) investigated the effects of a parent-administered early motor intervention program in the Neonatal Intensive Care Unit and explored parents' perceptions of administering the intervention, providing a foundation to explore both the potential and challenges of empowering parents in this role. Objective: To develop a comprehensive understanding of the depth and complexity of implementing parent-administered interventions. Methods: We applied a critical synthesis including five quantitative and one qualitative study of the NOPPI. Evidence was analyzed and combined to develop a conceptual framework. Results: The synthesis highlighted the critical role of active parental involvement and sense-making processes in fostering the motor development of very preterm infants. Using enactive framework as a guiding lens, three interconnected concepts emerged as central to understanding and implementing parent-administered interventions: knowing, doing, and being/becoming. These three dimensions are deeply interwoven and cannot be fully understood in isolation. Together, they form a comprehensive framework that underscores the complexity of parent-administered interventions highlighting knowledge development through embodied interactions, the importance of practical actions and strategies, and the dynamic and evolving identities of parents, infants, and physical therapists. Conclusion: The critical synthesis of the NOPPI highlights the need for early interventions to consider enactive concepts of knowing, doing, and being/becoming in the planning and implementation of early interventions to optimize outcomes for infants born very preterm and their parents.
Sørvoll et al. (Mon,) studied this question.