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Purpose:  To determine whether learning curves can be observed with deliberate practice when the goal is to apply a consistent rate of force at 5 N/second during pressure pain threshold (PPT) testing in healthy volunteers.  Methods:  In this prospective study, 17 clinician participants completed PPT targeted rate-of-application testing with healthy volunteers using three different feedback paradigms. The resultant performances of ramp rate during 36 trials were plotted on a graph and examined to determine whether learning curves were observed.  Results:  Clinicians were not consistent in the rate of force applied. None demonstrated a learning curve over the course of 36 trials and three testing paradigms.  Conclusion:  The results of this study indicate that applying a consistent 5 N/second of force is difficult for practising clinicians. The lack of learning curves observed suggests that educational strategies for clinicians using PPT may need to change.

Learning Curves Observed in Establishing Targeted Rate of Force Application in Pressure Pain Algometry