OBJECTIVE: To determine whether higher-intensity treadmill walking during rehabilitation in those newly able to walk after stroke is feasible, is detrimental to walking or is beneficial. DESIGN: A single-blind, randomized trial. SETTING: Two rehabilitation units. PARTICIPANTS: Thirty people with first stroke. INTERVENTIONS: Experimental group received 30 minutes of higher-intensity treadmill walking, three times per week for six weeks, in addition to usual physiotherapy. Control group received usual physiotherapy only. MAIN OUTCOME MEASURES: Feasibility was measured by examining compliance and adverse events. Detriment to walking was measured by examining pattern and quality. Benefit to walking was measured as capacity using six-minute walk test and speed, at baseline (week 0), immediately after (week 6) and at three months (week 18). RESULTS: Overall compliance was 89%, with no adverse events reported. There was no between-group difference in walking pattern and quality. By week 6, the experimental group improved walking capacity by 62 m (95% confidence interval (CI) 10 to 114), comfortable walking speed by 0.18 m/s (95% CI 0.07 to 0.29) and fast walking speed by 0.18 m/s (95% CI 0.03 to 0.35) more than the control group. By week 18, the experimental group was still walking 0.26 m/s (95% CI 0.12 to 0.41) faster than the control group. CONCLUSIONS: Higher-intensity treadmill walking during rehabilitation after stroke is feasible and not detrimental to walking pattern and quality in those newly able to walk. 94 participants are required to detect a between-group difference of 75 m on six-minute walk test (0.05 to 0.90) in future trials. TRIAL REGISTRATION: ACTRN12607000412437.

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