Comparison 2. BoNT‐A versus placebo or sham.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Gait: observational gait analysis; short‐term follow‐up	4	261	Risk Ratio (M‐H, Random, 95% CI)	1.66 [1.16, 2.37]
2 Gait: observational gait analysis; medium‐term follow‐up	3	248	Risk Ratio (M‐H, Random, 95% CI)	1.90 [1.32, 2.74]
3 Gait: kinematics; short‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Subtotals only
3.1 Peak ankle dorsiflexion in stance	1	19	Mean Difference (IV, Random, 95% CI)	15.9 [4.87, 26.93]
3.2 Peak ankle dorsiflexion in swing	1	19	Mean Difference (IV, Random, 95% CI)	10.2 [4.01, 16.39]
4 Function; short‐term follow‐up	4	305	Std. Mean Difference (IV, Random, 95% CI)	0.24 [‐0.35, 0.83]
4.1 Standard measures	2	108	Std. Mean Difference (IV, Random, 95% CI)	‐0.28 [‐0.66, 0.10]
4.2 Individualised measures	2	197	Std. Mean Difference (IV, Random, 95% CI)	0.71 [0.43, 1.00]
5 Function; medium‐term follow‐up	5	327	Std. Mean Difference (IV, Random, 95% CI)	0.28 [0.06, 0.49]
5.1 Standard measures	2	109	Std. Mean Difference (IV, Random, 95% CI)	0.05 [‐0.32, 0.43]
5.2 Individualised measures	3	218	Std. Mean Difference (IV, Random, 95% CI)	0.39 [0.12, 0.66]
6 Function; long‐term follow‐up	2	91	Std. Mean Difference (IV, Random, 95% CI)	‐0.07 [‐0.48, 0.35]
6.1 Standard measures	1	58	Std. Mean Difference (IV, Random, 95% CI)	‐0.22 [‐0.73, 0.30]
6.2 Individualised measures	1	33	Std. Mean Difference (IV, Random, 95% CI)	0.20 [‐0.49, 0.88]
7 Function (GMFM improvement); medium‐term follow‐up	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
8 Range of motion: passive ankle dorsiflexion; short‐term follow‐up	3	291	Mean Difference (IV, Random, 95% CI)	2.68 [0.12, 5.23]
9 Range of motion: passive ankle dorsiflexion; medium‐term follow‐up	2	150	Mean Difference (IV, Random, 95% CI)	1.57 [‐2.12, 5.25]
10 Range of motion; long‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Subtotals only
10.1 Ankle dorsiflexion	1	40	Mean Difference (IV, Random, 95% CI)	0.20 [‐4.88, 5.28]
10.2 Knee extension	1	19	Mean Difference (IV, Random, 95% CI)	‐5.6 [‐13.49, 2.29]
10.3 Hip abduction	1	11	Mean Difference (IV, Random, 95% CI)	9.6 [‐9.97, 29.17]
11 Quality of life (CPQOL); short‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
12 Quality of life (CPQOL); medium‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
13 Satisfaction (subjective scores); short‐term follow‐up	2	64	Risk Ratio (M‐H, Random, 95% CI)	1.20 [0.72, 2.01]
14 Satisfaction (subjective scores); medium‐term follow‐up	2	111	Risk Ratio (M‐H, Random, 95% CI)	1.32 [0.94, 1.83]
15 Satisfaction (COPM); short‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
16 Satisfaction (COPM); medium‐term follow‐up	2	74	Mean Difference (IV, Random, 95% CI)	0.96 [0.04, 1.88]
17 Satisfaction (COPM); long‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
18 Spasticity: ankle plantarflexors; short‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
19 Spasticity: ankle plantarflexors; medium‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
20 Spasticity; long‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Subtotals only
20.1 Ankle plantarflexors	1	42	Mean Difference (IV, Random, 95% CI)	0.10 [‐0.58, 0.78]
20.2 Hamstrings	1	10	Mean Difference (IV, Random, 95% CI)	‐1.0 [‐2.06, 0.06]
20.3 Hip adductors	1	13	Mean Difference (IV, Random, 95% CI)	0.1 [‐0.79, 0.99]
21 Adverse events	12	918	Risk Ratio (M‐H, Random, 95% CI)	1.29 [0.87, 1.93]
22 Sensitivity analysis: adverse events	11	860	Risk Ratio (M‐H, Random, 95% CI)	1.34 [0.90, 1.99]