Comparison 3. BoNT‐A versus serial casting.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Gait: observational gait analysis (PRS scores); short‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Subtotals only
2 Gait: observational gait analysis (PRS scores); medium‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Subtotals only
3 Gait: observational gait analysis (PRS scores); long‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Subtotals only
4 Gait: kinematics; short‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Subtotals only
4.1 Ankle dorsiflexion at initial contact	1	21	Mean Difference (IV, Random, 95% CI)	2.90 [‐2.90, 8.70]
4.2 Peak ankle dorsiflexion in stance	1	21	Mean Difference (IV, Random, 95% CI)	‐0.60 [‐5.78, 4.58]
5 Gait: kinematics; medium‐term follow‐up	3		Mean Difference (IV, Random, 95% CI)	Subtotals only
5.1 Ankle dorsiflexion at initial contact	2	47	Mean Difference (IV, Random, 95% CI)	6.59 [1.39, 11.78]
5.2 Peak ankle dorsiflexion in stance	3	83	Mean Difference (IV, Random, 95% CI)	3.03 [‐3.56, 9.62]
5.3 Peak ankle dorsiflexion in swing	2	62	Mean Difference (IV, Random, 95% CI)	0.11 [‐4.17, 4.38]
6 Gait: kinematics; long‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Subtotals only
6.1 Ankle dorsiflexion at initial contact	1	26	Mean Difference (IV, Random, 95% CI)	‐0.60 [‐6.37, 5.17]
6.2 Peak ankle dorsiflexion in stance	1	26	Mean Difference (IV, Random, 95% CI)	‐2.0 [‐8.50, 4.50]
6.3 Peak ankle dorsiflexion in swing	1	26	Mean Difference (IV, Random, 95% CI)	3.70 [‐0.80, 8.20]
7 Gait: speed; medium‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Subtotals only
8 Gait: speed; long‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Subtotals only
9 Function; medium‐term follow‐up	2	41	Mean Difference (IV, Random, 95% CI)	3.64 [‐1.55, 8.82]
10 Function (GMFM goal scores); short‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
11 Function (GMFM goal scores); long‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
12 Range of motion: passive ankle dorsiflexion; short‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
13 Range of motion: passive ankle dorsiflexion; medium‐term follow‐up	3	93	Mean Difference (IV, Random, 95% CI)	1.82 [‐2.26, 5.91]
14 Range of motion: passive ankle dorsiflexion; long‐term follow‐up	2	57	Mean Difference (IV, Random, 95% CI)	‐1.02 [‐5.63, 3.58]
15 Spasticity: ankle plantarflexors; short‐term follow‐up	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
16 Spasticity: ankle plantarflexors; medium‐term follow‐up	3	93	Mean Difference (IV, Random, 95% CI)	0.13 [‐0.25, 0.52]
17 Spasticity: ankle plantarflexors; long‐term follow‐up	2	57	Mean Difference (IV, Random, 95% CI)	0.17 [‐0.34, 0.67]
18 Adverse events	3	64	Risk Ratio (M‐H, Random, 95% CI)	0.59 [0.03, 11.03]
19 Sensitivity analyses: gait: kinematics (ankle dorsiflexion in stance)	3		Mean Difference (IV, Random, 95% CI)	Subtotals only
19.1 Short‐term follow‐up	1	21	Mean Difference (IV, Random, 95% CI)	‐0.60 [‐5.78, 4.58]
19.2 Medium‐term follow‐up	2	62	Mean Difference (IV, Random, 95% CI)	0.12 [‐4.56, 4.81]
19.3 Long‐term follow‐up	1	26	Mean Difference (IV, Random, 95% CI)	‐2.0 [‐8.50, 4.50]