D'Apote 2012.

Methods	Randomised, controlled, cross‐over trial
Participants	Number of participants: planned enrolment of 15 in each group. At the time of reporting, 9 children (sex unknown) were included in the intervention group. Baseline characteristics Average age: 7.6 years Participant inclusion criteria: not stated Participant exclusion criteria: not stated
Interventions	Group A: botulinum toxin A (6 U/kg for muscle) bilaterally in gastrocnemius + AFO + exercise Group B: botulinum toxin A
Outcomes	Primary outcome Improvement in toe walking (defined as greater than 50% of time spent heel‐toe walking) Technique: kinematics and kinetics associated with EMG and Vicon, scale not reported Time frame: measures were taken at baseline, 1, 3, and 6 months. Outcome type: interval Secondary outcomes Passive ankle dorsiflexion Technique: not reported Time frame: measures were taken at baseline, 1, 3, and 6 months after injection. Outcome type: interval
Conflicts of interest	Not reported
Funding	Not reported
Notes	Location: Italy (assumed)
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	The article states it is a cross‐over RCT however there is nothing that states how the participants are randomised or how treatments were allocated.
Allocation concealment (selection bias)	Unclear risk	The article does not state the method of allocation concealment, therefore we cannot place a judgement on this.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	The article does not state if any blinding was applied to either participants or personnel.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	The article does not state if any blinding was applied.
Incomplete outcome data (attrition bias) All outcomes	High risk	The article reports data for all participants enrolled in the study at the time of publication with reference to further participants being recruited.
Selective reporting (reporting bias)	High risk	No data were available for extraction.
Other bias	Unclear risk	The article reported interim outcome data from an incomplete study.