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Reliability was estimated by the intraclass correlation coefficient (ICC) and standard error of measurement (SEM) using linear mixed effects models, and the Bland\u2013Altman method of agreement.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, 45 patients with MND and 43 healthy controls were enrolled in this study. The ICC of the PFD was excellent and similar in both patients and controls (ICC <jats:sub>Patients<\/jats:sub> 99.5% <jats:italic>vs.<\/jats:italic> ICC <jats:sub>Controls<\/jats:sub> 98.6%) with a SEM of 6.2%. A strong examiner-induced ceiling effect in HHD was found when the participant\u2019s strength exceeded that of examiner. Employing the PFD increased the range of muscle strength measurements across individuals nearly twofold from 414 to 783\u00a0N.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Portable fixed dynamometry may significantly reduce examiner-induced ceiling effects, optimize the standardization of muscle strength testing, and maximize reliability. Ultimately, PFD may improve the delivery of care due to its potential for unsupervised, home-based assessments and reduce the burden to the patient of participating in clinical trials for MND or other neuromuscular diseases.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-020-10366-9","type":"journal-article","created":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T08:02:33Z","timestamp":1608710553000},"page":"1738-1746","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Portable fixed dynamometry: towards remote muscle strength measurements in patients with motor neuron disease"],"prefix":"10.1007","volume":"268","author":[{"given":"Jaap N. 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