Pain assessment in journal of athletic training articles 1992-1998: implications for improving research and practice.

OBJECTIVE: To examine, evaluate, and summarize the techniques used to assess pain in all the Original Research articles published in the Journal of Athletic Training from 1992 through 1998. A second objective was to determine whether any of the Original Research investigations that did not assess pain were on topics that included a pain component. A third purpose was to make recommendations for assessing pain in a clinical athletic training setting. DATA SOURCES: Every Original Research article published from 1992 through 1998 was reviewed independently by 2 of the authors to determine whether a pain assessment was included in the investigation and, if so, to evaluate the pain assessment technique used. DATA SYNTHESIS: A total of 23 (12.5%) of the 184 Original Research articles included some type of pain assessment. Most of these articles addressed the topics of delayed-onset muscle pain (43.5%), knee pain (17.4%), or pain resulting from cryotherapeutic procedures (17.4%). Most of the articles that included some type of pain measurement focused on the assessment of pain intensity using a category scale (17/23, 73.9%). In a substantial percentage of studies, a pain assessment tool that either lacked published supportive validity evidence (8/23, 34.8%) or was poorly constructed (because pain affect and pain intensity were confounded within a single scale) (7/23, 30.4%) was used. In a small number of articles on a topic directly relevant to pain (4/184, 2.2%), pain was not assessed, even though it could have provided useful information. CONCLUSIONS/RECOMMENDATIONS: Pain is a construct of interest to those conducting athletic training research. Pain measures were included in approximately 1 of every 8 Original Research articles published in the Journal of Athletic Training. However, investigators have too frequently measured pain in a limited fashion, often focusing only on pain intensity. Measuring other components of pain could provide additional opportunities for learning more about the relationships between pain and athletic training procedures. We recommend that athletic trainers involved in research, as well as those engaged in clinical practice, consider systematically employing valid, multidimensional measures of pain to better understand the relationships between pain and athletic training outcomes.