Back Foot Research Articles

Obstacles in Economic Growth of Madhya Pradesh

In any country, the fruits of economic growth transfers up to grass root level through various channels and modes. In India there is three tier system of transferring resources- especially financial resources - central government to states and from states to local bodies. This system has been questioned by different researchers from time to time as this flow of resources is not smooth but skewed. Many time gaps are observed between projections and actual receipts. This time lag pushed the development on back foot. This paper has analysed the trend and gaps in the financial transfers from centre to states. Further, it tried to identify hurdles on the ground of financial allocation to the state by finance commission. The analysis is based on the secondary sources of information. We have divided the administration in three tier- central, state and local bodies. The trend and gap in the financial allocation by the central government to the state and the state to the local bodies shows delay in disbursement. The funds flow from higher level governments to the lower level government is very week and lack devolution design or principle. This creates hindrance in the economic growth of the state. The results reveal higher actual expenditure than the approved plan due to gap between central and state financing. This indicates the deficit financing, increased burden and uneven growth in the economy. It may also imply a response to increasing inequalities in per capita incomes within state.

Undeclared Social Bracketing Of Ex-Soldiers: A Potential Bottleneck for Their Successful Transition

The ex-soldier, henceforth will be referred as ex throughout this paper, is someone who had retired from active defence service with pension from defence fund. The purpose of the study is to explore and explain the imperceptible humiliation (Undeclared Social Bracketing) ex-soldiers face in the course of their transition period and after that. The complex social set-up of the Indian civilization is passing through a technology modulated collective revolution; soldier cannot remain aloof. The soldier when in active service enjoy the highest regard in the society, but once he hangs up his uniform, he faces awkward situation. It is not easy for him to re-assimilate with the society which he left long ago. The transition from military life to civilian life is tricky issue for him. Surprisingly, the issue is not yet considered worthy of studying. I tried to highlight the finer points of the predicament the ex faces in the second innings of his life. Various rehabilitation and resettlement policies run by state as well as central governments too are on back foot at this front. The cause behind the situation is the goody-goody mindset and judgmental attitude of the members of the society. The author also tried to suggest some from the horse’s mouth simple solutions. However, constructive suggestions, views, reviews on the subject are warmly solicited.

The association between lower limb biomechanics and ball release speed in cricket fast bowlers: a comparison of high-performance and amateur competitors

The aim of this study was to compare the associations between lower limb biomechanics and ball release speed in 15 high-performance (HP) and 15 amateur fast bowlers. Kinematic and kinetic variables of the lower limbs collected in the laboratory environment with a 3D Vicon motion analysis system were compared between groups, as well as their associations with ball release speed. HP bowlers had a significantly higher run-up velocity at back foot impact but this difference became non-significant at ball release. Front knee kinematics were not statistically different, however effect sizes revealed medium-large differences with the HP group displaying a more extended knee joint at maximum flexion (d = 0.72) and ball release (d = 0.76). Only front hip positive power was significantly higher in the HP group and it was suggested that the probable cause was the HP bowlers having less knee flexion after front foot impact. From a joint power analysis, the extensor muscle groups of the hip and knee were shown to be important in developing ball release speed. This highlights the need for lower limb/core strength programmes to be multifaceted and focus on the muscles associated with both power and stability.

Lumbopelvic muscle activation patterns in adolescent fast bowlers

Introduction: Adolescent fast bowlers are prone to sustaining lumbar injuries. Numerous components have been identified as contributing factors; however, there is limited empirical evidence outlining how the muscles of the lumbopelvic region, which play a vital role in stabilising the spine, function during the bowling action and the influence of such activation on injuries in the fast bowler. Methods: Surface electromyography was utilised to measure the function of the lumbar erector spinae, lumbar multifidus, gluteus medius and gluteus maximus muscles bilaterally during the fast bowling action in a group of 35 cricket fast bowlers aged 12–16 years. Results: Two prominent periods of activation occurred in each of the muscles examined. The period of greatest mean activation in the erector spinae and multifidus occurred near back foot contact (BFC) and within the post-ball-release (BR) phase. The period of greatest mean activation for the gluteus medius and gluteus maximus occurred during phases of ipsilateral foot contact. Discussion: The greatest periods of muscle activation in the paraspinal and gluteal muscles occurred at times where vertical forces were high such as BFC, and in the phases near BR where substantial shear forces are present. Conclusion: The posterior muscles within the lumbopelvic region appear to play a prominent role during the bowling action, specifically when compressive and shear forces are high. Further research is required to substantiate these findings and establish the role of the lumbopelvic muscles in the aetiology of lumbar injury in the cricket fast bowler.

Biomechanics of Step Initiation After Balance Recovery With Implications for Humanoid Robot Locomotion.

Balance-recovery stepping is often necessary for both a human and humanoid robot to avoid a fall by taking a single step or multiple steps after an external perturbation. The determination of where to step to come to a complete stop has been studied, but little is known about the strategy for initiation of forward motion from the static position following such a step. The goal of this study was to examine the human strategy for stepping by moving the back foot forward from a static, double-support position, comparing parameters from normal step length (SL) to those from increasing SLs to the point of step failure, to provide inspiration for a humanoid control strategy. Healthy young adults instrumented with joint reflective markers executed a prescribed-length step from rest while marker positions and ground reaction forces (GRFs) were measured. The participants were scaled to the Gait2354 model in opensim software to calculate body kinematic and joint kinetic parameters, with further post-processing in matlab. With increasing SL, participants reduced both static and push-off back-foot GRF. Body center of mass (CoM) lowered and moved forward, with additional lowering at the longer steps, and followed a path centered within the initial base of support (BoS). Step execution was successful if participants gained enough forward momentum at toe-off to move the instantaneous capture point (ICP) to within the BoS defined by the final position of both feet on the front force plate. All lower extremity joint torques increased with SL except ankle joint. Front knee work increased dramatically with SL, accompanied by decrease in back-ankle work. As SL increased, the human strategy changed, with participants shifting their CoM forward and downward before toe-off, thus gaining forward momentum, while using less propulsive work from the back ankle and engaging the front knee to straighten the body. The results have significance for human motion, suggesting the upper limit of the SL that can be completed with back-ankle push-off before additional knee flexion and torque is needed. For biped control, the results support stability based on capture-point dynamics and suggest strategy for center-of-mass trajectory and distribution of ground force reactions that can be compared with robot controllers for initiation of gait after recovery steps.

Combined Treatment Fkt-Botulinum Toxin Type A (Btx-A) in Patients with Strumpell-Lorrain Disease.

The Hereditary Spastic Paraparesis (HSP) or Strumpell-Lorrain disease is a heterogeneous neurodegenerative disease of the spinal cord. It is genetically transmitted and characterized by a progressive muscle weakness, spasticity of the lower limbs and awkward gain. There is no specific pharmacological treatment. The pharmacological therapy decreases the muscle tone and prevents stiffening). Physiotherapy restrains the progression of muscle atrophy, delays contraction of the tendons and gives greater mobility to people affected by the disease. The aim of this study is to demonstrate the efficacy of the combined treatment Fkt and Btx-A in patients with HSP. Retrospective study was conducted recruiting ten patients with spasticity according to Asworth modified scale of at least 2 and with gait deficit. They received treatment for 5 years with incobotulinumtoxinA and physiokinesiotherapy for addressing spasticity in the lower limbs. We evaluated muscle tone with miometric measurement both at the first visit (T0), and at subsequent ones (T1 after 30 days, T2 after 3 months from the first infiltration, T3 after 4 months up to the date of the following infiltration, T4 after 5 months). Baropodometric examination has proven essential for the study of the distribution of loads in statics and dynamics. The data analysis regarding tone assessment through measurements with Myoton highlighted hypertonus reduction in all the three muscle groups examined at T1 and the maintenance of constant values up to 5 months after the first infiltration. It also showed an increase in the percentage of back foot loading in both feet up to T4 (new inoculation, p<0, 05%). Baropodometric examination in dynamics (in particular the speed of the step) showed a gradual increase in this parameter which reaches a peak at 5 months (p<0, 05%) and then declines again in conjunction with the next infiltration treatment. This study showed the benefit of combined treatment with Btx and Fkt. The use of a local muscle relaxant drug with a physical targeted exercise guarantees better mobility of the treated segments, reducing tendon retractions as much as possible, and guarantees an adequate postural alignment. Baropodometric examination highlights a more advantageous distribution load, quite essential for avoiding tendinitis due to overload. Our data observation in the 5 years study shows how the curve relative to the speed of step and the graphics related to the variations of muscle tone remain almost constant with detectable improvement.

Percutaneous versus Open Achilles Tendon Repair: A Case-Control Study

Purpose: We investigated whether percutaneous suturing of Achilles tendon ruptures showed better results and superiority in terms of clinical outcomes when compared to open suturing. Methods: We conducted a case-control study. Between 2009 and 2014, we performed surgical revisions of closed acute Achilles tendon ruptures in our hospital in 146 patients, of which 71 patients (2012-2014) received percutaneous suturing using Dresden instruments, and 75 patients (2009-2012) underwent open suturing. After a minimum period of 1 year post surgery, we performed clinical follow-up in 25 patients of each of the groups using the AOFAS hind foot score and the SF-12 questionnaire. Furthermore, we implemented a clinical questionnaire with a reference population of 200 healthy individuals. Results: Mean age in the total population of 146 patients was 47 years (range 21 to 83 years) at the time of surgery. The duration of the surgical procedure with percutaneous suturing was significantly shorter (24 versus 43 minutes, p ollow-up, no significant differences between the two groups were observed in terms of descriptive parameters. Furthermore, ultrasound examinations of both follow-up populations did not show any significant difference. From a clinical perspective, the good to very good results achieved with open suturing (as measured with the AOFAS hind foot score and the SF-12 questionnaire) have not been significantly improved with percutaneous suturing. The additional use of a new clinical score (with the reference population) demonstrated good to very good consistency with the established scores. Conclusion: In our population, percutaneous Achilles tendon suturing showed significantly lower complication rates and significantly shorter procedure times when compared to open suturing. However, percutaneous suturing did not show clinical improvements of the good to very good results that were achieved with open suturing (as measured with the AOFAS back foot score and the SF-12 questionnaire). The implementation of a new and simple score for the clinical evaluation of Achilles tendon injuries resulted in good to very good consistency with the established questionnaires and, thus, offered a straightforward and rapid alternative when compared to the more elaborate scores.

FEMINIZING WORLD POWER: A NEW CONSTELLATION OF WOMEN IN POLITICS?

It is an interesting time in world politics. Neoliberal globalization seems on back foot especially after an unexpected Brexit. Europe faces prospect of realigning itself after UK vote to leave EU. UK suffering from an immediate economic effect of Brexit has to renegotiate its international relations and trading agreements. EU faces what seem insuperable problems: its Mediterranean economies are in bad shape and EU is still recovering from Great Recession of 2007-8. Meanwhile Middle East is a boiling cauldron of regional, religious and ethnic conflicts involving a new round of US-Russia politics and strategic action over Assad's regime and larger regional bloc conflicts. Syrian civil war is in its seventh year and refugees from Syrian have made up one of largest migration crises mainly from displaced refugees in Middle East since WWII with strong eco- nomic, social and security consequences for EU. ISIL continues to grow and extend its influence in Levant. Militant Islam with all its splinter groups continues to conduct its suicide and car bombing attacks on European civil society. There are also new crises brewing in South China Seas with China's imperial ambitions as well as international difficulties with so-called rogue states like Korea. likelihood of nuclear proliferation is probably greater at this point historically than any time since end of WWII.At same time specter of Donald Trump grows larger as US November elections approach and rhetoric that spills forth from him on issues of NATO, Russia, and China scare most mainstream foreign policy specialists. His threatened withdrawal of major partnerships and international treaties including recent Paris environmental agreement poses a real cause for alarm.The world leadership problems and issues confronting heads of state are probably more complex and intrinsically more difficult than at any time in past. At same time it appears that emergence of women leaders currently in power is highest it has ever been with election or appointment of some twenty-two female heads of state and leaders in 2015.1 Caroline Howard and Michael K. Ozanian (2012) named The 100 Most Powerful beginning with Angela Merkel, Hillary Clinton, Dilma Rousseff, Melinda Gates, Jill Abramson, Sonia Ghandi, Michelle Obama, Christine Lagarde, Janet Napolitano, and Sheryl Sandberg under following description:There's official power, which comes in form of a head of state or CEO, and then there's transformational force of impact, stemming from magnitude of reach and influence. Here are entrepreneurs and early adapters, celebrity role models, activist billionaires and philanthropists who are healing world - all ranked by dollars, media presence and impact.Yet as Swanee Hunt (2007), in an article Let Rule in Foreign Affairs, reminds us, progress toward leadership and equal power for women has not been easy or straightforward:Women have made significant strides in most societies over last century, but trend line has not been straight. In recent interviews with hundreds of female leaders in over 30 countries, I have discovered that where women have taken leadership roles, it has been as social reformers and entrepreneurs, not as politicians or government officials. This is unfortunate, because world needs women's perspectives and particular talents in top positions.She refers to Francis Fukuyama's 1998 article in Foreign Affairs Women and Evolution of World Politics that speculates women's political leadership would bring about a more cooperative and less conflict-prone world of World Politics. She concludes that Fukuyama's promise has yet to be fulfilled. Hunt (2007) suggests that shift of women from civil society into government will help to develop a healthier political culture and highlights the advantages women have over men's brawny style of governance, whether because of biology, social roles, or a cascading combination of two. …

Doping is Bless or Curse in Sports

The best athlete of the world in sports contests are certainly trained for extreme powers at their sports. The entire athlete utilizes all of their resources in getting the peak performance level, of being they know the sports rules, to which they must abide. Doping remains bless for athlete in primitives, while it is turned to curse at the back foot. The study examines the impacts of doping in relation to the history of doping, keeping in view the objectives, Doping is dangerous for young and vulnerable sportsman. Doping is contrary to the spirit of sports. In order to hand best results a likert type scale with three options and ten questions was constructed regarding ‘Doping Is Bless or Curse in Sports’ responded by the players and physicians of district karak.

Stress Fracture of the Fibular Sesamoid Bone of the Foot in Cricket: An Unusual Injury in Bowlers

ABSTRACT An unusual case of fibular sesamoid stress fracture in the back foot of a bowler is presented. The diagnosis was delayed due to the lack of awareness of the support medical staff of the cricketer. Special radiological views and computed tomographic scans confirmed the diagnosis; nonoperative measures cured the pain, but this recurred on subsequent bowling activities. The current player gave up the game, but the literature supports operative intervention in cases that fail conservative regimens. This case is presented to highlight the occurrence of this rare injury in fast bowlers, and we recommend careful examination of the foot when it is the trailing foot, because this has significant forefoot dorsiflexion during the stance phase. How to cite this article Dhillon H, Behera P, Prabhakar S, Dhillon S, Dhillon MS. Stress Fracture of the Fibular Sesamoid Bone of the Foot in Cricket: An Unusual Injury in Bowlers. J Foot Ankle Surg (Asia-Pacific) 2016;3(1):59-62.

Determination of the vertical ground reaction forces acting upon individual limbs during healthy and clinical gait

In gait lab, the quantification of the ground reaction forces (GRFs) acting upon individual limbs is required for dynamic analysis. However, using a single force plate, only the resultant GRF acting on both limbs is available.The aims of this study are (a) to develop an algorithm allowing a reliable detection of the front foot contact (FC) and the back foot off (FO) time events when walking on a single plate, (b) to reconstruct the vertical GRFs acting upon each limb during the double contact phase (DC) and (c) to evaluate this reconstruction on healthy and clinical gait trials.For the purpose of the study, 811 force measurements during DC were analyzed based on walking trials from 27 healthy subjects and 88 patients. FC and FO are reliably detected using a novel method based on the distance covered by the centre of pressure. The algorithm for the force reconstruction is a revised version of the approach of Davis and Cavanagh [24]. In order to assess the robustness of the algorithm, we compare the resulting GRFs with the real forces measured with individual force plates. The median of the relative error on force reconstruction is 1.8% for the healthy gait and 2.5% for the clinical gait. The reconstructed and the real GRFs during DC are strongly correlated for both healthy and clinical gait data (R2=0.998 and 0.991, respectively).

Economic Vulnerability and Political Responses to International Pressure: Liechtenstein, Switzerland and the Struggle for Banking Secrecy

AbstractAfter doggedly opposing any increase in exchange of information on tax matters for several decades, both Liechtenstein and Switzerland have made significant concessions over recent years. However, the two countries have reacted rather differently to international pressure: while Liechtenstein has adopted a more proactive approach, offering far‐reaching bilateral deals to several major economies, Switzerland has been slow to react to international pressure, despite calls for a more proactive strategy by its financial services industry. We suggest that these differences have a range of causes; in Liechtenstein, in particular, the pressure was more evenly distributed, thus allowing the financial services industry to close ranks and use its privileged access to the government to shape the government's response decisively. By contrast, there was internal division in the Swiss financial services industry and it was soon on the back foot in public debate, eventually losing control over the issue.

Upper Extremity Muscle Activity During The Lacrosse Shot

PURPOSE: To determine if lacrosse shaft stiffness influenced upper extremity muscle activity and/or shot velocity. METHODS: Muscle activity of the biceps brachii, triceps brachii, flexor carpi radialis, and extensor carpi radialis of the arm closer to the head of the shaft was measured (EMG, 1500Hz). Subjects (n=5; 20±2.4 years, 79.8±6.87 kg, 177±4.52 cm) with 4.5±2.96 years of lacrosse experience completed shots using four shafts of different stiffnesses. Subjects and research team were blinded to shaft stiffness. Subjects shot 5 times per shaft with order of shaft randomized. Subjects were instructed to shoot with maximum effort from a stationary position (i.e., one step forward with the front foot; the back foot remained on the ground). Subjects were given time to warm up with practice shots on net. A video camera was used to record discrete kinematic events of the shot. Shot velocity was recorded for each shot and averaged across the 5 trials per condition. Video data was visually inspected and the time of occurrence of maximum elbow flexion, ball release, and maximum elbow extension were identified. EMG data were processed by removing any zero offset, full-wave rectifying the data and averaging across two phases defined by the kinematic discrete events. Muscle activity for each phase and shot velocity was compared between shafts using a repeated measures ANOVA (α=0.05). RESULTS: Neither muscle activity for any muscle analyzed nor shot velocity were influenced by shaft stiffness (p>0.05). CONCLUSION: Having a high shot velocity can be advantageous to a lacrosse player. Besides the player ability, lacrosse equipment may be a factor in determining shot velocity. However, in this experiment, shaft stiffness did not have an influence on muscle activity or shot velocity.

Design and Concept Evaluation of Tricycle for Aged and Orthopedic Differentially Abled Persons

The conventional hand powered tricycle in the Indian market used by the aged and differentially abled (orthopedic) person considered for evaluation in this work. The existing conventional tricycle consumes high energy for paddling. In case of terrain climbing more energy is required for driving. So the orthopedic person gets exhausted. The current design also lacks ergonomic comfort as the crank is kept fixed and the non adjustable seat which leads to back pain and muscle fatigue. This paper aims at proposing new alternate design which overcomes all the limitations in the current design. The new design is provided with features of adjustable back rest, foot rest, and adjustable crank and related accessories. Thus the improved design meets the ergonomic issues which were lagging in the current design.

What Is the Future of Transitional Justice?

INTRODUCTION The term ‘transitional justice’ evokes hope and renaissance. For more than a quartercentury, when the concept of transitional justice was first mooted, postconflict and other tormented societies have attempted to embrace it as a bridge to a more hopeful future. A number of states in the depths of despair and countries wracked by seemingly endless cycles of violence see transitional justice tools as a possible midwife of a democratic, rule-of-law state. In many circles, transitional justice has become an article of faith as a catalyst for reclaiming societies in political and social imbalance and dysfunction. Senior statesmen and leading academics have endorsed the critical place of transitional justice in returning societies to civilization. Diverse regions of the globe – from Europe and Central and Latin America to Africa and Asia – have latched on to the glimmer of hope offered by transitional justice ideas, processes and institutions. Almost three decades later, the body of evidence suggests a mixed record. There have many successes of transitional justice initiatives, but there have also been many challenges. This special issue of IJTJ seeks to excavate these hopes and fears of a relatively novel idea. It has sought out new and divergent voices, many with a critical lens, to ask nagging questions about the enterprise of transitional justice. The emergence of transitional justice roughly coincided with the end of the Cold War and the euphoria of the presumed triumph of free market ideologies and political liberation around the globe. In Africa, Asia and Latin America, one-party regimes and opaque dictatorships – most supported by either the West or the East – gave way to new experiments in democratic rule. Most were emerging from long nights of tyranny and despotism. Such global upheaval and regime change had not been witnessed since the era of decolonization. In Latin America, brutal military kleptocracies were in retreat, and in Africa military fascism and single-party states were put on their back foot by pro-democracy activists and human rights advocates. The close of the last century and the beginning of this one were marked by hope and the promise

Cricket Biomechanics Analysis of Skilled and Amateur Fast Bowling Techniques

ABSTRACT Cricket fast bowling action involves complex three-dimensional (3D) motion of the body and poses a high risk of injury more so in schoolboys. It is not known how the bowling technique varies between skilled and less skilled fast bowlers. The aim of this study is to compare the differences in bowling technique between young sub-elite (skilled) and amateur university level cricketers. Twelve players, 6 skilled and six amateur, were attached with 35 retro-reflective markers using the full body Plug-in-Gait marker set and asked to bowl 6 deliveries at a good length. Their bowling action was captured with 12 Vicon 3D cameras and the ground reaction force was measured using AMTI force plates. The best delivery from each bowler was selected. Their bowling action types were classified and parameters like shoulder counter rotation (scr), pelvicshoulder separation angle at back foot contact, trunk lateral flexion, front knee angle, front foot vertical ground reaction force (vGRF) and ball release speed were measured. The results were analyzed with Levene's test for Equality of Variances and a t-test for equality of means. The skilled bowlers showed faster ball release speed and experienced larger vGRF while the other parameters did not show any significant differences. How to cite this article Thiagarajan KA, Parikh T, Sayed A, Gnanavel MB, Arumugam S. Cricket Biomechanics Analysis of Skilled and Amateur Fast Bowling Techniques. J Postgrad Med Edu Res 2015;49(4):173-181.

Locomotion of inchworm-inspired robot made of smart soft composite (SSC)

A soft-bodied robot made of smart soft composite with inchworm-inspired locomotion capable of both two-way linear and turning movement has been proposed, developed, and tested. The robot was divided into three functional parts based on the different functions of the inchworm: the body, the back foot, and the front foot. Shape memory alloy wires were embedded longitudinally in a soft polymer to imitate the longitudinal muscle fibers that control the abdominal contractions of the inchworm during locomotion. Each foot of the robot has three segments with different friction coefficients to implement the anchor and sliding movement. Then, utilizing actuation patterns between the body and feet based on the looping gait, the robot achieves a biomimetic inchworm gait. Experiments were conducted to evaluate the robot’s locomotive performance for both linear locomotion and turning movement. Results show that the proposed robot’s stride length was nearly one third of its body length, with a maximum linear speed of 3.6 mm s−1, a linear locomotion efficiency of 96.4%, a maximum turning capability of 4.3 degrees per stride, and a turning locomotion efficiency of 39.7%.

Security metrics to manage change

Enterprise security is constantly evolving. The larger the enterprise, the more changes there are to its network. New hires come in, employees are promoted, leave or are reassigned to new roles. It's the natural order of business and happens in any progressive organisation. What all this change does, however, is create self-inflicted security risks that can be prevented. IT industry analyst Gartner has projected that, “through 2018, more than 95% of firewall breaches will be caused by firewall misconfigurations, not firewall flaws”. Networks are subject to constant change, but security often struggles to keep up. One issue is a lack of understanding about an organisation's security posture, and this isn't helped by poor communication. Jody Brazil of FireMon explains how IT security teams can be effective at their job only when senior executives understand the importance of security and know the full picture. By not communicating effectively with board members, security teams are putting themselves on the back foot when it comes to protecting their organisations.

NUMSA and Solidarity’s Responses to Technological Changes at the ArcelorMittal Vanderbijlpark Plant: Unions Caught on the Back Foot

Under the impact of globalisation and intensified international competition there has been an increased use of technology in the production processes in South African enterprises. No specific study of the impacts of technological changes on work and workers, and how trade unions have responded to technological changes at the workplace has been undertaken in post-apartheid South Africa. This article seeks to fill this void by examining trade union responses to technological changes at the ArcelorMittal Vanderbijlpark Plant. The responses of National Union of Metalworkers of South Africa (NUMSA; a predominantly black union) and Solidarity (a predominantly white union) to technological changes were generally reactive or on the back foot, with a general focus on wage bargaining by both trade unions.

Present and Potential Use of Spinal Cord Stimulation to Control Chronic Pain

Background: Spinal cord stimulation is an intervention that has become increasingly popular due to the growing body of literature showing its effectiveness in treating pain and the reversible nature of the treatment with implant removal. It is currently approved by the FDA for chronic pain of the trunk and limbs, intractable low back pain, leg pain, and pain from failed back surgery syndrome. In Europe, it has additional approval for refractory angina pectoris and peripheral limb ischemia. Objective: This narrative review presents the current evidence supporting the use of spinal cord stimulation for the approved indications and also discusses some emerging neuromodulation technologies that may potentially address pain conditions that traditional spinal cord stimulation has difficulty addressing. Study Design: Narrative review. Results: Spinal cord stimulation has been reported to be superior to conservative medical management and reoperation when dealing with pain from failed back surgery syndrome. It has also demonstrated clinical benefit in complex regional pain syndrome, critical limb ischemia, and refractory angina pectoris. Furthermore, several cost analysis studies have demonstrated that spinal cord stimulation is cost effective for these approved conditions. Despite the lack of a comprehensive mechanism, the technology and the complexity in which spinal cord stimulation is being utilized is growing. Newer devices are targeting axial low back pain and foot pain, areas that have been reported to be more difficult to treat with traditional spinal cord stimulation. Percutaneous hybrid paddle leads, peripheral nerve field stimulation, nerve root stimulation, dorsal root ganglion, and high frequency stimulation are actively being refined to address axial low back pain and foot pain. High frequency stimulation is unique in that it provides paresthesia free analgesia by stimulating beyond the physiologic frequency range. The preliminary results have been mixed and a large randomized control trial is underway to evaluate the future of this technology. Other emerging technologies, including dorsal root ganglion stimulation and hybrid leads, also show some promising preliminary results in non-randomized observational trials. Limitation: This review is a primer and not an exhaustive review for the current evidence supporting the use of spinal cord stimulation and precursory discussion of emerging neuromodulation technologies. This review does not address peripheral nerve stimulation and focuses mainly on spinal cord stimulation and touches on peripheral nerve field stimulation. Conclusions: Spinal cord stimulation has demonstrated clinical efficacy in randomized control trials for the approved indications. In addition, several open label observational studies on peripheral nerve field stimulation, hybrid leads, dorsal root ganglion stimulation, and high frequency stimulation show some promising results. However, large randomized control trials demonstrating clear clinical benefit are needed to gain evidence based support for their use. Key words: Spinal cord stimulation, chronic pain; low back pain, high frequency stimulation, peripheral nerve field stimulation, dorsal root ganglion stimulation, failed back surgery syndrome, complex regional pain syndrome, critical limb ischemia, refractory angina pectoris