Background: Individuals with acute-onset central nervous system (CNS) injury, including stroke, motor incomplete spinal cord injury, or traumatic brain injury, often experience lasting locomotor defi cits, as quantifi ed by decreases in gait speed and distance walked over a specifi c duration (timed distance). The goal of the present clinical practice guideline was to delineate the relative effi cacy of various interventions to improve walking speed and timed distance in ambulatory individuals greater than 6 months following these specifi c diagnoses. Methods: A systematic review of the literature published between 1995 and 2016 was performed in 4 databases for randomized controlled clinical trials focused on these specifi c patient populations, at least 6 months postinjury and with specifi c outcomes of walking speed and timed distance. For all studies, specifi c parameters of training interventions including frequency, intensity, time, and type were detailed as possible. Recommendations were determined on the basis of the strength of the evidence and the potential harm, risks, or costs of providing a specifi c training paradigm, particularly when another intervention may be available and can provide greater benefi t. Results: Strong evidence indicates that clinicians should offer walking training at moderate to high intensities or virtual reality-based training to ambulatory individuals greater than 6 months following acuteonset CNS injury to improve walking speed or distance. In contrast, weak evidence suggests that strength training, circuit (ie, combined) training or cycling training at moderate to high intensities, and virtual reality-based balance training may improve walking speed and distance in these patient groups. Finally, strong evidence suggests that body weight-supported treadmill training, robotic-assisted training, or sitting/standing balance training without virtual reality should not be performed to improve walking speed or distance in ambulatory individuals greater than 6 months following acute-onset CNS injury to improve walking speed or distance.