Koman 1994.

Methods	Method of randomisation: not described Blinding: double‐blind study Intention‐to‐treat analysis: no Loss of follow‐up: no losses to follow‐up Unit of analysis: lower limb for local measures and child for global measures
Participants	Place: 1 centre in the USA Period of study: not described Number assigned: 12 Number assessed: 12 6 BoNT‐A group 6 placebo group Inclusion criteria: Non‐progressive lesion resulting in spasticity (CP) Equinovarus or equinovalgus dynamic foot deformities unresponsive to conventional treatment Exclusion criteria: Significant health issues Age: Both groups (range): 4 to 11 years Gender: Not described Motor distribution: Both groups: 4 hemiplegia; 8 diplegia GMFCS: Not described, but since all children were walkers, likely GMFCS I, II, and III
Interventions	BoNT‐A group: Initial BoNT‐A injection into the gastrocnemius muscles (onabotulinumtoxinA) 1 U/kg per side. In equinovarus deformities, the tibialis posterior was also injected. Second BoNT‐A injection (onabotulinumtoxinA) 2 U/kg per side at the same injection sites Placebo group: Placebo (saline) injections in a similar fashion as in the BoNT‐A group
Outcomes	Length of follow‐up: The final evaluation was made after a 4‐ to 6‐week interval from the first injection Primary outcomes: Physician Rating Scale Biodex isokinetic computerised dynamometry Physiotherapy evaluations Parent/guardian assessment
Notes	Comments: Since both injections were given only 2 weeks apart, and at a low dose each, we considered this as a single‐injection study for the purposes of our review Source of funding: not reported Conflicts of interest: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Comment: not described
Allocation concealment (selection bias)	Unclear risk	Comment: not described
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Comment: double‐blind study
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Comment: outcome assessors were blind to group allocation
Incomplete outcome data (attrition bias) All outcomes	Low risk	Comment: no missing outcome data
Selective reporting (reporting bias)	Unclear risk	Comment: study protocol not available. It appears that the relevant outcomes were addressed.
Other bias	Low risk	Comment: no other sources of bias identified