Study designs of evaluations included in the review
Randomised controlled trials (RCTs) or self-controlled experimental studies were eligible for inclusion in the review.
Specific interventions included in the review
Intramuscular injection of BtA (a range of regimens was reported) was compared with a control in receipt of no intervention, with physiotherapy management with and without casting or splinting, or with placebo saline injection. In one included study, the intervention (BtA) groups, also received casting and physiotherapy, while in another both the BtA group and the fixed plaster cast group underwent night plasters.
Participants included in the review
Children aged from 0 to 17 years with a diagnosis of cerebral palsy, who were ambulant with lower limb disability affecting their gait, were eligible for inclusion in the review.
Outcomes assessed in the review
Only studies with validated tools as outcome measures were eligible for inclusion. These were: impairment measures of muscle spasticity, length and joint range of motion using the Modified Ashworth Scale, the Modified Tardieu Scale and goniometry; the Gross Motor Functional Measure and ambulation status; gait analysis using subjective scales (Global Scoring Scale, Physician Rating Scale, 2-dimensional (video) analysis, 3-dimensional (VICON) analysis and electromyography.
How were decisions on the relevance of primary studies made?
The authors do not state how the papers were selected for the review, or how many of the reviewers performed the selection.