Do we always prioritize balance when walking? Towards an integrated model of task prioritization

Previous studies suggest that strategies such as "posture first" are implicitly employed to regulate safety when healthy adults walk while simultaneously performing another task, whereas "posture second" may be inappropriately applied in the presence of neurological disease. However, recent understandings raise questions about the traditional resource allocation concept during walking while dual tasking. We propose a task prioritization model of walking while dual tasking that integrates motor and cognitive capabilities, focusing on postural reserve, hazard estimation, and other individual intrinsic factors. The proposed prioritization model provides a theoretical foundation for future studies and a framework for the development of interventions designed to reduce the profound negative impacts of dual tasking on gait and fall risk in patients with neurological diseases. © 2012 Movement Disorder Society.