Study of Force Changes Based on Orthotic Elements Under the First Ray

The first ray plays a fundamental role in foot biomechanics, particularly in stabilizing the medial longitudinal arch and enabling efficient weight transfer during the mid-stance and propulsion phases of gait. When dorsiflexed—a condition known as metatarsus primus elevatus—especially in its flexibl...

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Main Authors: Marina Ballesteros-Mora, Pedro V. Munuera-Martínez, Natalia Tovaruela-Carrión, Antonia Sáez-Díaz, Javier Ramos-Ortega
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Applied Sciences
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Online Access:https://www.mdpi.com/2076-3417/15/14/7708
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author Marina Ballesteros-Mora
Pedro V. Munuera-Martínez
Natalia Tovaruela-Carrión
Antonia Sáez-Díaz
Javier Ramos-Ortega
author_facet Marina Ballesteros-Mora
Pedro V. Munuera-Martínez
Natalia Tovaruela-Carrión
Antonia Sáez-Díaz
Javier Ramos-Ortega
author_sort Marina Ballesteros-Mora
collection DOAJ
description The first ray plays a fundamental role in foot biomechanics, particularly in stabilizing the medial longitudinal arch and enabling efficient weight transfer during the mid-stance and propulsion phases of gait. When dorsiflexed—a condition known as metatarsus primus elevatus—especially in its flexible form, this structure disrupts load distribution, impairs propulsion, and contributes to various clinical symptoms. Despite its clinical importance, the biomechanical impact of orthotic elements placed beneath the first ray remains underexplored. This study aimed to quantify the variations in medio-lateral (Fx), antero-posterior (Fy), and vertical (Fz) force vectors generated during gait in response to different orthotic elements positioned under the first ray. A quasi-experimental, post-test design was conducted involving 22 participants (10 men and 12 women) diagnosed with flexible metatarsus primus elevatus. Each participant was evaluated using custom-made insoles incorporating various orthotic elements, while gait data were collected using a dynamometric platform during the mid-stance and propulsion phases. Significant gait-phase-dependent force alterations were observed. A cut-out (E) reduced medio-lateral forces during propulsion (<i>p</i> < 0.05), while a kinetic wedge (F) was correlated with late-stance stability (r = −0.526). The foot posture index (FPI)/body mass index (BMI) mediated the vertical forces. The effect sizes reached 0.45–0.42 for antero-posterior force modulation. Phase-targeted orthoses (a cut-out for propulsion, a kinetic wedge for late stance) and patient factors (FPI/BMI) appear to promote biomechanical efficacy in metatarsus primus elevatus, enabling personalized therapeutic strategies.
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spelling doaj-art-a44261fbfd104f578e8773e36c056b442025-08-20T02:45:37ZengMDPI AGApplied Sciences2076-34172025-07-011514770810.3390/app15147708Study of Force Changes Based on Orthotic Elements Under the First RayMarina Ballesteros-Mora0Pedro V. Munuera-Martínez1Natalia Tovaruela-Carrión2Antonia Sáez-Díaz3Javier Ramos-Ortega4Private Practice, Clínica Mir, Avenida España 39, La Línea de la Concepción, 11300 Cádiz, SpainDepartment of Podiatry, University of Seville, C. Avicena, 41009 Seville, SpainDepartment of Podiatry, University of Seville, C. Avicena, 41009 Seville, SpainAxioma Comunicaciones, Av. Vía Apia, 7, 41006 Seville, SpainDepartment of Podiatry, University of Seville, C. Avicena, 41009 Seville, SpainThe first ray plays a fundamental role in foot biomechanics, particularly in stabilizing the medial longitudinal arch and enabling efficient weight transfer during the mid-stance and propulsion phases of gait. When dorsiflexed—a condition known as metatarsus primus elevatus—especially in its flexible form, this structure disrupts load distribution, impairs propulsion, and contributes to various clinical symptoms. Despite its clinical importance, the biomechanical impact of orthotic elements placed beneath the first ray remains underexplored. This study aimed to quantify the variations in medio-lateral (Fx), antero-posterior (Fy), and vertical (Fz) force vectors generated during gait in response to different orthotic elements positioned under the first ray. A quasi-experimental, post-test design was conducted involving 22 participants (10 men and 12 women) diagnosed with flexible metatarsus primus elevatus. Each participant was evaluated using custom-made insoles incorporating various orthotic elements, while gait data were collected using a dynamometric platform during the mid-stance and propulsion phases. Significant gait-phase-dependent force alterations were observed. A cut-out (E) reduced medio-lateral forces during propulsion (<i>p</i> < 0.05), while a kinetic wedge (F) was correlated with late-stance stability (r = −0.526). The foot posture index (FPI)/body mass index (BMI) mediated the vertical forces. The effect sizes reached 0.45–0.42 for antero-posterior force modulation. Phase-targeted orthoses (a cut-out for propulsion, a kinetic wedge for late stance) and patient factors (FPI/BMI) appear to promote biomechanical efficacy in metatarsus primus elevatus, enabling personalized therapeutic strategies.https://www.mdpi.com/2076-3417/15/14/7708footfirst rayfoot orthosesforces
spellingShingle Marina Ballesteros-Mora
Pedro V. Munuera-Martínez
Natalia Tovaruela-Carrión
Antonia Sáez-Díaz
Javier Ramos-Ortega
Study of Force Changes Based on Orthotic Elements Under the First Ray
Applied Sciences
foot
first ray
foot orthoses
forces
title Study of Force Changes Based on Orthotic Elements Under the First Ray
title_full Study of Force Changes Based on Orthotic Elements Under the First Ray
title_fullStr Study of Force Changes Based on Orthotic Elements Under the First Ray
title_full_unstemmed Study of Force Changes Based on Orthotic Elements Under the First Ray
title_short Study of Force Changes Based on Orthotic Elements Under the First Ray
title_sort study of force changes based on orthotic elements under the first ray
topic foot
first ray
foot orthoses
forces
url https://www.mdpi.com/2076-3417/15/14/7708
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