Variations in centre of pressure and balance performance induced by footwear drop in healthy adults

Background Posturography is a diagnostic technique that quantifies postural control through Centre of Pressure (CoP) displacement analysis on a force platform. Footwear characteristics, particularly heel-to-toe drop, may influence balance by modifying plantar pressure distribution and proprioceptive feedback. The aim of this study was to evaluate the impact of different footwear drops (0 mm, 5 mm, 10 mm) on postural control in healthy young adults, considering sex, BMI, and shoe size. Methods A cross-sectional study was conducted in 117 participants (56 men, 61 women) using the Dinascan/IBV ® platform and the Romberg test. CoP displacement and velocity were analyzed. Results Significant differences were observed in CoP total displacement ( p < 0.001), mean velocity ( p < 0.001), and medio-lateral dispersion ( p = 0.024) when comparing 0 mm to 5 mm and 10 mm drops. Sex differences were significant at 0 mm drop for maximum medio-lateral force ( p < 0.001) and mean velocity ( p = 0.042), with men exhibiting greater values. At 5 mm drop, men showed significantly higher swept area ( p = 0.029) and anteroposterior displacement ( p = 0.007) than women. Conclusions Small variations in footwear drop can affect postural control, particularly in the medio-lateral plane. Sex and BMI significantly influence CoP behavior, suggesting the need to consider these factors in footwear design and clinical balance assessments.