Optimization and Randomized Controlled Evaluation of Plantar White Noise Vibration for Balance Improvement in Young Adults

Postural control is essential for daily function, and while stochastic resonance (SR) enhances balance in clinical populations, its efficacy in healthy young people remains underexplored. This study investigated (1) biomechanical effects of multisite plantar vibration on postural stability using center-of-pressure (CoP) parameters, and (2) short-term and sustained effects on balance performances. Phase 1 enrolled six participants to identify the optimal plantar stimulation configuration and to evaluate acute electromyographic responses under threshold-level vibration. Phase 2 evaluated long-term efficacy through an eight-week sham-controlled parallel-group randomized controlled trial. In this trial, eight participants received vibration combined with balance training, and another eight participants completed the same training protocol using sham insoles without vibration, analyzing CoP parameters (95% ellipse area, path length) and muscle activation (tibialis anterior, medial gastrocnemius, peroneus longus, extensor digitorum longus). Results showed full-site vibration reduced CoP area versus control (265.66 ± 188.6 mm2 vs. 437.84 ± 190.95 mm2, p < 0.05) without altering ankle muscle activation (all p > 0.05). Longitudinal analysis revealed CoP area reduction (−4.88 ± 10.42%) in the intervention group versus sham (p < 0.001), with maximum anterior displacement increasing by 25.03% during vibration (p < 0.05). Plantar white-noise vibration modulates CoP oscillations without neuromuscular activation changes, demonstrating that full-site stimulation acutely enhances postural stability while sustained intervention improves dynamic balance control.