## 4 Discussion  
The LEMOCOT was thoroughly examined for reliability and validity in patients with MS. The test proved easy to administer, with participants able to understand how to appropriately perform the test with minimal instruction provided. No other special training or standardization was required between examiners prior to the test administration. Although blinding of the examiners could not be performed, the examiners themselves agreed not to influence participants at all during the test performance, omitting any verbal or other encouragement during the 20 s the LEMOCOT lasted. All instruction on correct test performance was provided beforehand and was standardized between examiners, as presented in Section 2. For the sample of patients tested, the results showed no differences between the dominant and non-dominant LLs in people with early- and middle-stage MS; therefore, no asymmetries in the coordination of the LL movements in the present study could be identified. One might speculate that such coordination symmetry between the lower limbs might be related to force symmetry. However, in other studies such as the study by [PERSON] et al. (2021) [9], participating subjects with MS showed strength asymmetries in both upper limbs (ULs) and LLs, but that particular study included participants with MS that had progressed to a severe stage with equally severe impairments. Muscle weakness is considered one of the first symptoms of MS and indicates strength asymmetries in most muscle groups resulting in fatigue and gait disturbances in these individuals [9; 11]. In our study, it was also observed that for test-retest reliability, the mean of the targets in the second measurement (both on the same and a different day) was slightly higher. A previous study examining test-retest reliability [16] reported a similar pattern of results in individuals with motor coordination problems, mostly patients with stroke. [PERSON] et al. (2005) [16] attributed this performance enhancement to the patient's familiarity with the test at the second measurement. Since there was no intervention program between test-retest measurements, most likely the performance enhancement noted could also have been due to patient familiarization or temperature variation, as not all patients were re-measured at exactly the same time of day, depending on their appointment times, and fatigue relating to high temperatures may have affected measurements. However, the intra- and inter-rater reliability was found to be excellent for both LLs, with ICC values ranging between 0.94 and 0.99, comparatively higher than another previous reliability study conducted in patients with stroke [16]. The SEM for test-retest measurements taken on either the same day by the same or different examiners or on different days by two different examiners was between 1.5 and 3.5 targets, representing the amount of variability due to measurement error upon repeated measurements. Similar SEM values (1.55-3.87 targets) were reported in a previous study of the LEMOCOT's reliability in patients with stroke [16]. The MDC values denoting the amount of true change in a variable were 5.9-8.3 targets for the dominant LL and 4.22-9.58 targets for the non-dominant LL, depending on the type of reliability measured, indicating a true change occurring if 9-10 more targets were registered during the conduct of the LEMOCOT. Therefore, our study demonstrated adequate inter- and intra-rater reliability of this test in a Greek population of people with MS, satisfactory for further use in clinical practice. To test for convergent validity, the LEMOCOT scores' association with the FSTS test, BBS, EDSS, LEFS scales, and age were examined. The strongest negative correlation of the LEMOCOT test was found to be with the FSTS test. According to [21], the FSTS test is characterized as a time trial because patients must complete five repetitions of alternate sitting-to-standing as quickly as possible.