A new multidimensional measurement tool for monitoring pain and post-injury effects in athletes: a development and validation study

Currently, no valid and reliable instrument comprehensively monitors athletes’ health and assesses the multifaceted effects of sports injuries. We aimed to develop a tool to detect injury-related pain and evaluate the consequences of such injuries. We created the Pain Monitoring and Injury Impact Scale for Athletes (PAMIIS), which consists of a Pain Detection Diagram and an Injury Impact Scale. PAMIIS was designed and improved upon expert, partner, and participant opinions and a literature review. The content and scope of the initial 37-item tool were checked with a pilot test on 30 athletes. The item analysis was conducted with 148 participants, while 55 athletes were retested to assess test-retest reliability. PAMIIS sub-scores were compared with the Visual Analog Scale (VAS), the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O), and the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H), for concurrent validity. Construct validity was examined via Exploratory Factor Analysis (EFA), followed by Confirmatory Factor Analysis (CFA) on responses from 90 athletes using the finalized version. PAMIIS demonstrated excellent internal consistency (Cronbach’s α = 0.971) and test-retest reliability (ICC = 0.980). Strong correlations were found with OSTRC-O ( r = 0.796) and OSTRC-H ( r = 0.786) scores. EFA revealed a four-factor structure with 32 items, which was subsequently supported through CFA. PAMIIS is a valid and reliable multidimensional instrument for assessing the perceived physical and psychosocial consequences of sports injuries in athletes. By capturing athletes’ experiences, it provides an understanding of the impact of injuries from their perspective. By assessing pain across multiple predefined time frames, PAMIIS facilitates the differentiation of acute-onset and overuse-related pain complaints and provides a structured means of monitoring their course. Routine implementation in sports settings may aid early symptom detection and structured rehabilitation monitoring, ultimately supporting athletes’ well-being. This study was registered at ClinicalTrials.gov (NCT06955364).