Steenbeek 2005.

Methods	Method of randomisation: not described Blinding: no blinding Intention‐to‐treat analysis: no Loss of follow‐up: no Unit of analysis: child
Participants	Place: 1 centre in the Netherlands Period of study: not described Number assigned: 11 Number assessed: 11 5 group A 6 group B Inclusion criteria: Children with CP Disabling spasticity of the lower extremity Knowledge of the Dutch language Exclusion criteria: Not described Age: All groups (mean/range): 5.0/3 to 12 years Gender: Not described Motor distribution: All groups: 6 diplegia; 5 hemiplegia GMFCS: All groups: 4 level I; 3 level II; 3 level III; 1 level IV; 0 level V
Interventions	Intervention phase: Single‐cycle BoNT‐A injections (onabotulinumtoxinA) 4 to 6 U/kg/muscle group. Maximum dose of 50 U per injection site. Multilevel injections in 5 children and single‐level injections in 6 children Regular physical therapy and occupational therapy Baseline phase: Regular physical therapy and occupational therapy
Outcomes	Length of follow‐up: Follow‐up of 14 weeks Group A: baseline phase 8 weeks and treatment phase 6 weeks Group B: baseline phase 6 weeks and treatment phase 8 weeks Weekly assessments for both groups Primary outcome: Goal Attainment Scaling (blinded video scoring) Secondary outcomes: Goal Attainment Scaling (non‐blinded measure by the treating physiotherapist) Modified Ashworth Scale
Notes	Comments: Randomised multiple baseline/treatment phase trial design. All children received the intervention with different control and treatment phases. 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)	High risk	Comment: no allocation concealment
Blinding of participants and personnel (performance bias) All outcomes	High risk	Comment: no blinding of participants and personnel
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Comment: outcome assessors blinded for the primary outcomes
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	Unclear risk	Comment: randomised, multiple baseline/treatment phase trial design may be a source of bias. All children received the intervention with 2 different control and treatment phases.