**Acknowledgements**

*Connectivity and Functional Specialization in the Brain*

of critical illness and improved its physical function [20].

settled on the first day to the third day.

cognitive impairment in moderate time in the ICU.

nerves to recognize that when the patient bed rest does not happen mechanical unloading and decreased neuromuscular activity. The results of research supported by the theories Margaret that moment activity neuromuscular becomes better, it will inhibit the complex adaptation response (protein synthesis), protein degradation, and apoptosis of muscle cells [1, 2, 6, 7–13, 15, 21, 30, 31, 45–56]. Mechanisms that occur are the main contributor muscle atrophy, loss of muscle strength in critically ill patients during bed rest. Physical-cognitive therapy is expected to increase muscle metabolism which further increases the formation of protein to energy solution for patient immobilization or bed rest. Physical-Cognitive therapy can improve physical function declined over the patient in the ICU, it was supported by the results of research Thomsen stated that ambulation and early mobilization in critically ill patients in the ICU were able to improve the patient's physical function and also decrease the use of sedation [57]. Critically ill patients in ICU should be done as soon as possible physical mobility exercises to improve muscle metabolism and does not activate a response or apoptosis mechanism. The results of research supported by Elliott in the prevention of damage to physical function after discharge from the ICU who stated that early mobility can mitigate the negative impact

Physical-cognitive therapy significantly impacts on improving the cognitive functions of Critically ill patients in ICU. These results correspond with the results of a study that critically ill patients in the ICU can experience mental health disorders such as anxiety and they have cognitive impairment and poor sleep quality.5 Improved cognitive function was not affected by the characteristics of the study subjects from the intervention group. The decline in cognitive function is influenced also by gender by the statistical results and strengthened by the results of cognitive function decline Wreksoatmojo is motivated by a variety of risk factors that cannot be avoided such as age and gender, as well as some physical conditions and diseases [58]. The decline in cognitive function can slow recovery in patients. The research subjects in the control group were restless anxiety and pain scale

The results also showed increased cognitive function occurred in all subdomains variable orientation, regression, attention-calculation, recall, and language. Research shows that physical-cognitive therapy can improve the function of any existing variables. The results of research supported by the results of studies that suggest that cognitive therapy can change the perception of self in patients with heart problems [59]. Research subjects most heart problems with a variety of conditions and consciousness and care in the ICU. The subjects of the study intervention group experienced an increase in all indicators of cognitive function. Cognitive function has several major functions in which work is recertified function, memory function, the function of thinking, and repressive function. This repressive function involves the ability to make the selection process, clarify and integrate the information provided. Researchers on the provision of physical-cognitive therapy provide the stimuli of orientation, registration, attention-calculation, recall until the language with the hope of the study subjects were able to do the selection process to integrate more complex information. The research subjects' control group decreased cognitive function have a significant relationship to independence by the results of research conducted by Balquis [60]. Subjects have been unable to carry out compliance activities of daily needs and also experience pain at a mild to moderate level. It also can affect the patient's condition, especially the condition of his illness. Based on the results that research subjects have the most control group

The research subjects in the control group with a decline in cognitive function may occur and demonstrate emotional response after discharge from the ICU such

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I would like to offer my special thanks to patients in ICU Kediri Baptist Hospital. I would like to thank dr. Jati Listiyanto Pujo, Sp. An., KIC., Erina Purwanti (intensivist), Dr. dr. Awal Prasetyo, Sp.THT-KL, M. Kes, and Ns. Reni Sulung Utami, S. Kep, MSc for their help in this research.
