Abstract: Systems and method for monitoring gait dynamics are disclosed. The performance of an orthotic or prosthetic device or other device associated with a limb may be measured based on the resistance of a bending sensor. Data from the sensors is gathered or processed, particularly for purposes of alignment, safety, failure, usage, selection, and artificial proprioception. Information relating to the device may be outputted visually or auditorily to an individual.

Abstract: A hollow tubulous composite structure and method for prosthetic limbs is described.

Abstract: A keel is provided having a spring portion and a connecting portion. The spring portion can have a channel that is compressible during compression of the keel. A variably adjustable compression member can be provided. The connecting portion is rigidly connected to a rigid center support. A heel is also provided having a spring portion and a connecting portion. The spring portion can have a top open channel formed therein. The channel is compressible during compression of the heel. A variably adjustable compression member can be placed within the channel. Alternatively, heel and keel springs located at least partially external of the heel and keel can be provided. The heel spring can act against either the keel or the center support, and the keel spring can act against either the heel or the center support.

Abstract: The invention provides a prosthetic foot device including an elongated upper forefoot portion extending through an upper attachment section, forwardly through an arch section, and to a toe section positioned at a toe location of a natural foot. The foot device also includes an elongated lower forefoot portion extending through an upper attachment section attached to the attachment section of the upper forefoot portion, and forwardly under the arch section of the upper forefoot portion to a terminal end positioned under the ball location of a natural foot and rearward of the toe section of the upper forefoot portion.

Abstract: A prosthetic foot includes a rod having a substantially spherical head and a shank extending from the head. A connector is pivotally coupled to the spherical head of the rod. The connector has a coupling configured to attach to the stump of an amputee. A wear plate is disposed on the shank of the rod adjacent the connector. The wear plate is sized and shaped to contact the connector as the connector pivots on the spherical head of the rod. A spring is removably disposed on the shank of the rod and spaced apart from the wear plate a predetermined distance. The spring is compressible by the rod when the rod is disposed in a prosthetic foot and an axial load is applied to the rod.

Abstract: Systems and method for monitoring gait dynamics are disclosed. The performance of an orthotic or prosthetic device or other device associated with a limb may be measured based on the resistance of a bending sensor. Data from the sensors is gathered or processed, particularly for purposes of alignment, safety, failure, usage, selection, and artificial proprioception. Information relating to the device may be outputted visually or auditorily to an individual.

Abstract: Embodiments of low cost prosthetic feet include a footplate with a connection mechanism embedded within a first foam element having a first stiffness. A second foam element is bonded to the footplate and has a recess in a proximal surface and a stiffness greater than the first foam element. The second foam element may have a portion extending past the terminal end of the footplate. A cosmesis encloses the components of the prosthetic foot. A third foam element that extends through the cosmesis into the second foam element may be provided. The third foam element may have a higher stiffness than the first and second foam elements.

Abstract: A keel is provided having a spring portion and a connecting portion. The spring portion can have a split section that is divided into two sections. Each section can have a top open channel formed therein. Each channel is compressible during compression of the keel. A variably adjustable compression member can be provided. The connecting portion is rigidly connected to a rigid center support. The top of the center support can have a threaded connector, which allows for vertically adjustable connection of an adjacent prosthetic component. A heel is also provided having a spring portion and a connecting portion. The spring portion can have a top open channel formed therein. The channel is compressible during compression of the heel. A variably adjustable compression member can be placed within the channel. A processor can be provided for controlling the amount of compression of each compression member.

Abstract: A keel is provided having a spring portion and a connecting portion. The spring portion can have a split section that is divided into two sections. Each section can have a top open channel formed therein. Each channel is compressible during compression of the keel. A compression member can be placed within each channel to control or limit the amount of keel spring compression. The connecting portion is rigidly connected to a rigid center support. The top of the center support can have a threaded connector, which allows for vertically adjustable connection of an adjacent prosthetic component. A heel is also provided having a spring portion and a connecting portion. The spring portion can have a top open channel formed therein. The channel is compressible during compression of the heel. A compression member can be placed within the channel to control or limit the amount of heel spring compression.

Abstract: A mobility assistance apparatus and a method for improving the mobility of a person using a walking aid, such as a cane, crutch, or walker, involve use of a device for ground engagement with ambulating using the walking aid. In a preferred example the device is a resilient lower extremity prosthesis that is capable of storing and releasing energy to generate propulsive force to aid mobility. The prosthesis has a foot, ankle and shank. The shank has a lower portion that is anterior facing convexly curved for generating forward propulsion with ambulating to aid mobility.

Abstract: A prosthetic foot includes an elongated foot member, extending between a toe section positioned at a toe location of a natural foot and a heel section positioned at a heel location of a natural foot. The elongated foot member also extends through an elevated arch section positioned between the toe section and heel section at an approximate arch location of a natural foot. An arch block is disposed below the elongated foot member under the elevated arch section. The arch block is sized and shaped to substantially fill a space or volume under the arch section. The arch block has geometric and physical properties that facilitate medial to lateral rotation to the prosthetic foot.

Abstract: A stable shock absorbing prosthetic foot that transfers energy between heel strike and toe-off. A toe plate is separated from one or more other plates by a bumper assembly located at each of the toe end and heel end of the foot. Certain embodiments of the shock absorbing foot of the present invention are designed for use with a prosthetic ankle. A torsion adapter may also be used to attach a prosthetic foot of the present invention to the remainder of a prosthesis.

Abstract: Prosthetic feet are described comprising a curvilinear spring element, including a rounded portion transitioning between upper and lower extensions, the upper extension including a mounting section/region between the curved portion and a distal end of the upper extension. At least one leaf spring element spans a gap between the upper and lower extension sections, and a resilient footbed is attached to the lower extension. Such feet are typically set within a cosmetic cover for and fit within a shoe for use.

Abstract: A prosthetic foot includes a foot member, a heel member operatively coupled to the foot member. At least one of the heel member and foot member define an arch portion that faces a support surface that the prosthetic foot contacts during use. An insole member contacts said arch portion, the insole member configured to facilitate a rollover of the prosthetic foot in at least one of a lateral-medial and a medial-lateral direction during ambulation.

Abstract: Compositions are provided for a prosthetic ankle comprising: a joint housing having a bottom surface, a clevis coupled to the joint housing such that the clevis can rotate about the joint housing, a prosthetic coupling structure that couples the clevis to an amputee, and an articulating joint contained in the joint housing. Additionally, a portion of the bottom surface of the joint housing can be curved allowing a substrate a preset amount of flexion when coupled thereto and flexed in a concave position.

Abstract: The present foot prosthesis includes various structural features that provide the foot with advantageous rollover properties. In certain embodiments, the foot guides rollover toward the medial side. For example, an asymmetrical upper element and a correspondingly shaped resilient ankle member support more of the wearer's weight on the lateral side as the foot rolls over. In another embodiment, stiffeners added to the resilient ankle member increase the stiffness on the lateral side relative to the medial side. In certain other embodiments, the foot provides progressively increasing support from mid stance through toe off. For example, a gap between the resilient ankle member and the lower element closes during the later portion of the wearer's gait. The closing gap increases a contact area between the resilient ankle member and the lower element, providing progressively increasing support. In another embodiment, the foot includes a gap between a lower front edge of an attachment adapter and the upper element.

Abstract: The present foot prosthesis includes various structural features that provide the foot with advantageous rollover properties. In certain embodiments, the foot guides rollover toward the medial side. For example, an asymmetrical upper element and a correspondingly shaped resilient ankle member support more of the wearer's weight on the lateral side as the foot rolls over. In another embodiment, stiffeners added to the resilient ankle member increase the stiffness on the lateral side relative to the medial side. In certain other embodiments, the foot provides progressively increasing support from mid stance through toe off. For example, a gap between the resilient ankle member and the lower element closes during the later portion of the wearer's gait. The closing gap increases a contact area between the resilient ankle member and the lower element, providing progressively increasing support. In another embodiment, the foot includes a gap between a lower front edge of an attachment adapter and the upper element.

Abstract: A foot plate for a prosthetic foot includes a sole plate and a layer with laterally variable stiffness disposed above the sole plate. The layer has a medial portion and a lateral portion. The lateral portion has a stiffness different than a stiffness of the medial portion, such as a greater stiffness to provide a relatively softer instep and a relatively stiffer out-step.

Abstract: Prosthetic foot, of the type with energy recovery, comprising at least one spring blade (2) made of composite material fixed integrally to the ankle or tibia, or to a support (1) fixed to the ankle or tibia, and designed to permit dynamic set-down on the ground (S). It further comprises a rigid arm (3) connected to the blade (2) via a first connecting means (22), which permits a pivoting articulation of the arm (3) on the blade (2) on an axis transverse to the latter; and in that the rigid arm (3) has a part (31) designed to permit a substantially vertical set-down on the ground, preferably to the rear of the ankle or tibia; and in that, moreover, the rigid arm (3) and the blade (2) are connected via a second connecting means (32) arranged in an area distant from the first connecting means (22).

Abstract: A prosthetic foot (124) incorporates a foot keel (165) and a calf shank (126) connected to the foot keel to form an ankle joint area of the prosthetic foot. The foot keel has forefoot and hindfoot portions and an upwardly arched midfoot portion extending between the forefoot and midfoot portions. The calf shank includes an anterior facing convexly curved lower portion which is adjustably attached at a portion thereof to the foot keel by way of a releasable fastener arrangement. The upper end of the calf shank is movable longitudinally of the foot keel in response to force loading and unloading the calf shank during use of the prosthetic foot. A device (125) connected between the upper end of the calf shank and the lower portion of the prosthesis can be used to assist posterior movement of the upper end of the calf shank and control anterior movement of the upper end of the calf shank during use of the prosthesis.

Abstract: A prosthetic foot includes a pair of elongated forefoot leaf springs with proximal ends coupled to an attachment member and extending in an arc to distal ends with the forefoot leaf springs being oriented with one over another. The pair of forefoot leaf springs has different lengths and is coupled to one another at the proximal and distal ends defining an open, uninterrupted gap between the forefoot leaf springs. A pair of hinge connections can be disposed each at a different one of the proximal and distal ends of the pair of elongated forefoot leaf springs. The pair of forefoot leaf springs together has a non-linear force deflection under loading during gait.

Abstract: A keel for a prosthetic foot. In an embodiment, the keel comprises a unitary keel body having a longitudinal axis and a length L. The keel body includes a forefoot portion, a heel portion, and an ankle portion extending therebetween. In addition, the keel comprises a first bumper disposed in a first capture cavity in the ankle portion. The first bumper has a central axis that is substantially perpendicular to the longitudinal axis of the keel body in top view.

Abstract: Certain embodiments of the invention relate to increasing the functionality of a transfemoral prosthetic device. In one embodiment, the transfemoral prosthetic device is configured such that the prosthetic knee maintains a load consistent with a healthy knee walking on level ground, while the prosthetic ankle adjusts for the incline or decline. In certain embodiments, adjustments, such as a toe lift function, are automatically performed after about three strides of the transfemoral prosthetic device user and/or when each of the strides has a stride speed of at least about 0.55 meters/second.

Abstract: A prosthetic foot (64) incorporates a foot keel (65) and a calf shank (73) connected to the foot keel to form an ankle joint area (74) of the prosthetic foot. The foot keel has forefoot and hindfoot portions (67, 66) and a relatively long midfoot portion (68) extending between and upwardly arched from the forefoot and midfoot portions. The calf shank includes a downward convexly curved lower end which is attached at a portion thereof to the keel midfoot portion by way of an adjustable fastener arrangement (75). The adjustable fastener arrangement permits adjustment of the alignment of the calf shank and the foot keel with respect to one another in the longitudinal direction of the foot keel for tuning the performance of the prosthetic foot.

Abstract: The prosthetic foot (1) consists of three or four laminas, a lower lamina (1a) defining the under-heel and the foot front, a rear lamina (1b) defining the heel and functioning as the Achilles tendon and as the soleus muscle, two upper laminas (1c and 1d) defining the front part of the foot and performing the function of the front tibial muscle, and a connector (2) in proximity to the ankle to serve as a coupling for a tube (3). The aim of this prosthetic foot is to simulate the behaviour of the human foot, in such a manner as to ensure good rear flexure and effective plantar flexure. The use of three or four laminas enables continuous energy absorption/return by the foot such as to allow assisted walking by the prosthetic foot at every moment. The prosthetic foot always operates via at least two laminas, of which one absorbs and the other returns energy. The device is arranged to be housed within an aesthetic covering.

Abstract: A process for continuously performing polymerization processes, wherein monomer(s), catalysts, and initiators are added continuously to a backmixed mixing kneader (1-1.3) with a length/diameter ratio of 0.5-3.5 and backmixed therein with already reacted product, and the reacted product is simultaneously drawn off continuously from the mixing kneader (1-1.3).

Abstract: The prosthetic foot (1) is a lamina of composite material with a characteristic J-shape, fixable by a TT bracket (2) directly to a socket (3) containing the stump, i.e. the residual part of the amputated lower limb, in the case of users with transtibial amputations, or to a TF bracket (2a) itself fixable to a mechanical knee (G) fixable to a socket (3a), in the case of users with transfemoral amputations. Said socket (3 or 3a) has a main axis (5) defined by the loading straight line by which the user, after applying the prosthesis, discharges body weight in the static position, and passing through a point (4) identifying the femoral epicondyle, real in the case of transtibial users and virtual in the case of trans femoral users, but coinciding with the centre of rotation of the knee during mid-stance.

Abstract: The present invention discloses an instrumented prosthetic foot for use with an actuated leg prosthesis controlled by a controller, the instrumented prosthetic foot comprising a connector to connect the instrumented prosthetic foot to the leg prosthesis, an ankle structure connected to the connector, a ground engaging member connected to the ankle, at least one sensor for detecting changes in weight distribution along the foot, and an interface for transmitting signals from the sensor to the controller.

Abstract: A keel is provided having a spring portion and a connecting portion. The spring portion can have a split section that is divided into two sections. Each section can have a top open channel formed therein. Each channel is compressible during compression of the keel. A variably adjustable compression member can be provided. The connecting portion is rigidly connected to a rigid center support. The top of the center support can have a threaded connector, which allows for vertically adjustable connection of an adjacent prosthetic component. A heel is also provided having a spring portion and a connecting portion. The spring portion can have a top open channel formed therein. The channel is compressible during compression of the heel. A variably adjustable compression member can be placed within the channel. A processor can be provided for controlling the amount of compression of each compression member.

Abstract: A lower leg prosthetic device includes an ankle assembly coupled to a foot assembly via a rigid pin extending through an oversized shaft having a pair of resilient bushings partially seated therein, which resiliently limit the relative pivot of the foot and ankle assemblies about axes orthogonal to that of the pin. A pair of cushions disposed between the assemblies forward and rearward of the pin resiliently limits relative pivot of the assemblies about the pin axis. The foot assembly includes an elongate, planar plantar member mounted to and extending forwardly of a support element having a comparatively lower elastic modulus. The foot assembly cooperates with the coupling assembly to absorb stride-related forces in a graduated manner by relative forward pivoting of the ankle assembly relative in a first phase of striding motion, and by upward flexion of the forward end of the plantar member in a second phase.

Abstract: A prosthetic foot includes a rod having a substantially spherical head and a shank extending from the head. A connector is pivotally coupled to the spherical head of the rod. The connector has a coupling configured to attach to the stump of an amputee. A wear plate is disposed on the shank of the rod adjacent the connector. The wear plate is sized and shaped to contact the connector as the connector pivots on the spherical head of the rod. A spring is removably disposed on the shank of the rod and spaced apart from the wear plate a predetermined distance. The spring is compressible by the rod when the rod is disposed in a prosthetic foot and an axial load is applied to the rod.

Abstract: A prosthetic foot (70) incorporates a foot keel (77) and a calf shank (72) connected to the foot keel to form an ankle joint area of the prosthetic foot. The foot keel has forefoot and hindfoot portions and an upwardly arched midfoot portion extending between the forefoot and midfoot portions. The calf shank includes a downward convexly curved lower end which is adjustably attached at a portion thereof to the foot keel by way of a releasable fastener arrangement. The upper end of the calf shank is movable longitudinally of the foot keel in response to force loading and unloading the calf shank during use of the prosthetic foot. A device (71) connected between the ends of the calf shank limits the extent of the motion of the upper end of the calf shank relative to the lower end and foot keel.

Abstract: A prosthetic foot comprises a ground engaging bottom resilient member, a resilient heel member, and a resilient toe member that collectively circumscribe an open volumetric space. The members resilient compress to absorb compressive force throughout the entire stride of an individual utilizing the foot.

Abstract: Embodiments of low cost prosthetic feet include a footplate with a connection mechanism embedded within a first foam element having a first stiffness. A second foam element is bonded to the footplate and has a recess in a proximal surface and a stiffness greater than the first foam element. The second foam element may have a portion extending past the terminal end of the footplate. A cosmesis encloses the components of the prosthetic foot. A third foam element that extends through the cosmesis into the second foam element may be provided. The third foam element may have a higher stiffness than the first and second foam elements.

Abstract: Embodiments of low cost prosthetic feet include a footplate with a connection mechanism embedded within a first foam element having a first stiffness. A second foam element is bonded to the footplate and has a recess in a proximal surface and a stiffness greater than the first foam element. The second foam element may have a portion extending past the terminal end of the footplate. A cosmesis encloses the components of the prosthetic foot. A third foam element that extends through the cosmesis into the second foam element may be provided. The third foam element may have a higher stiffness than the first and second foam elements.

Abstract: Embodiments of low cost prosthetic feet include a footplate with a connection mechanism embedded within a first foam element having a first stiffness. A second foam element is bonded to the footplate and has a recess in a proximal surface and a stiffness greater than the first foam element. The second foam element may have a portion extending past the terminal end of the footplate. A cosmesis encloses the components of the prosthetic foot. A third foam element that extends through the cosmesis into the second foam element may be provided. The third foam element may have a higher stiffness than the first and second foam elements.

Abstract: An artificial foot having a longitudinal axis extending from a heel area to a toe area, a length, a width and a height is provided. The artificial foot includes a connection to a lower leg part, an upper supporting structure in the direction of height, an elastic sole structure extending from the heel area to the toe area, an elastic connecting element arranged between the upper supporting structure and the sole structure, and a coupling system. The upper supporting structure is connected to the sole structure approximately in a middle of the foot with respect to its length by means of the coupling system. The coupling system allows a relative tilting motion between the upper supporting structure and the sole structure while keeping a distance between the upper supporting structure and the sole structure in a middle of the coupling system constant, at least while a patient places weight on it when standing.

Abstract: A modular prosthetic foot characterized by an ankle component; a forefoot component having a circular part with a rounded top surface and at least one flat side surface, said circular part being connected to a rear part of the forefoot component; a forefoot cushion bumper positioned around the circular part; and a heel component.

Abstract: The invention relates to an artificial foot with a connecting part for a lower leg part, a forefoot part which is pivotably connected to the connecting part by means of an upper coupling element and a lower coupling element in such a way that an angular position of the connecting part controls an angular position of the forefoot part, one of the coupling elements extending into a heel area of the foot.

Abstract: A prosthetic ankle and foot combination has an ankle joint mechanism constructed to allow damped rotational movement of a foot component relative to a shin component. The mechanism provides a continuous hydraulically damped range of ankle motion during walking with dynamically variable damping resistances, and with independent variation of damping resistances in the plantarflexion and dorsiflexion directions. An electronic control system coupled to the ankle joint mechanism includes at least one sensor for generating signals indicative of a kinetic or kinematic parameter of locomotion, the mechanism and the control system being arranged such that the damping resistances effective over the range of motion of the ankle are adapted automatically in response to such signals. Single and dual piston hydraulic damping arrangements are disclosed, including arrangements allowing independent heel-height adjustment.

Abstract: A system for a lower extremity prosthesis comprising a foot, an ankle and a shank, has a posterior calf device (169) on the prosthesis to store energy during force loading of the prosthesis and return the stored energy during force unloading to increase the kinetic power generated for propulsive force by the prosthesis in gait. The device in several embodiments includes at least one elongated member (171) such as a flexible strap extending between an upper portion of the shank and a lower portion of the prosthesis, and at least one coiled spring (170) which has a free end connected to the elongated member. The coiled spring is expanded by the elongated member in response to anterior movement of the upper end of the shank for storing energy.

Abstract: A prosthetic foot (70) incorporates a foot keel (71) and a calf shank (72) connected to the foot keel to form an ankle joint area of the prosthetic fool. The foot keel has forefoot and hindfoot portions and an upwardly arched midfoot portion extending between the forefoot and midfoot portions. The calf shank includes a downward convexly curved lower end which is adjustably attached at a portion thereof to the foot keel by way of a releasable fastener arrangement which includes a coupling element (73) intermediate the calf shank and foot keel. The coupling element includes a resilient material forming a joint permitting subtalar joint-like motion of the prosthetic foot in gait.

Abstract: A prosthetic foot is provided with an ankle plate for attachment to a lower leg prosthesis and supporting a composite frame having a hollow composite biasing structure, preferably in the form of a generally helical spring curved about a vertical axis.

Abstract: A prosthetic foot device includes an elongated upper forefoot portion, an ankle portion, and a lower footplate. The forefoot portion can extend rearwardly through an upper attachment section, downwardly through an ankle section, forwardly through an arch section, and to a toe section. The ankle portion can attach to the forefoot portion, and can extend rearwardly through an upper attachment section, downwardly through an ankle section, forwardly under the ankle section of the forefoot portion, and rearwardly to a heel section, in a substantial s-shaped profile. The lower footplate is disposed under the ankle and forefoot portions, and can extend through a heel section, an arch section, and to a toe section. The upper forefoot portion, the ankle portion, and the lower footplate are flexible to store energy and resilient to return energy.

Abstract: A prosthetic foot (147) has a longitudinally extending foot keel (149) and a resilient, monolithically formed calf shank (148) extending upwardly from the foot keel to form an ankle joint area of the prosthetic foot and a lower, prosthetic part of a leg above the ankle joint area for connection with a lower extremity prosthetic socket on a person's leg stump. At least the lower portion of the calf shank extending upwardly from the foot keel is anterior facing convexly curved. The shank and at least a portion of the foot keel are monolithically formed.

Abstract: A prosthetic foot (124) incorporates a foot keel (165) and a calf shank (126) connected to the foot keel to form an ankle joint area of the prosthetic foot. A device (125) connected between the upper end of the calf shank and the lower portion of the prosthesis can be used to assist posterior movement of the upper end of a calf shank and control anterior movement of the upper end of the calf shank during use of the prosthesis. The device (125) has springs which store energy during force loading with anterior motion of the upper end of the calf shank in gait and which, during force unloading, return the stored energy as kinetic power for adding to the propulsive force on the user's body generated by the prosthesis in gait.

Abstract: A prosthetic foot includes an elongated foot member, extending between a toe section positioned at a toe location of a natural foot and a heel section positioned at a heel location of a natural foot. The elongated foot member also extends through an elevated arch section positioned between the toe section and heel section at an approximate arch location of a natural foot. An arch block is disposed below the elongated foot member under the elevated arch section. The arch block is sized and shaped to substantially fill a space or volume under the arch section. The arch block has geometric and physical properties that facilitate medial to lateral rotation to the prosthetic foot.

Abstract: A prosthetic foot incorporate a foot keel and a calf shank connected to the foot keel to form an ankle joint area of the prosthetic foot. The foot keel has forefoot and hindfoot portions and a relatively long midfoot portion extending between and upwardly arched from the forefoot and midfoot portions. The calf shank includes a downward convexly curved lower end which is attached at a portion thereof to the keel midfoot portion by way of an adjustable fastener arrangement. The foot has biplanar motion capability and, in a preferred form, also has high low dynamic response characteristics. The adjustable fastener arrangement permits adjustment of the alignment of the calf shank and the foot keel with respect to one another in the longitudinal direction of the foot keel for tuning the performance of the prosthetic foot.

Abstract: A prosthetic foot device with variable stiffness response includes a variable energy transfer mechanism disposed between first and second foot members to transfer a variable amount of energy between the members during use. A chamber is associated with one of the first and second foot members, and a piston is associated with another of the first and second foot members and is movable in the chamber. At least one aperture is formed between the piston and the chamber. A variable viscosity fluid is disposed in the chamber and displaceable through the at least one aperture between the piston and the chamber to allow fluid to flow within the chamber between opposite sides of the piston. The variable viscosity fluid has a viscosity that is variable to vary an ability of the variable viscosity fluid to flow through the at least one aperture.

Abstract: The invention provides a prosthetic foot device including an elongated upper forefoot portion extending through an upper attachment section, forwardly through an arch section, and to a toe section positioned at a toe location of a natural foot. The foot device also includes an elongated lower forefoot portion extending through an upper attachment section attached to the attachment section of the upper forefoot portion, and forwardly under the arch section of the upper forefoot portion to a terminal end positioned under the ball location of a natural foot and rearward of the toe section of the upper forefoot portion.