b.6 Minute Walk Test (MWT)

*Connectivity and Functional Specialization in the Brain*

reduce protein formation to energy breakdown during patient immobilization or

response and affect the response of the hormone oxytocin.

Alzheimer's, and others (**Figure 2**).

*The immobilization-induced catabolic response.*

a.Time Up and Go [36]

ments including Time up and Go (TUG) Test

Critically ill patients in the ICU show that 70% of the minimum activity will lose muscle mass after bed rest, especially in the lower extremities [19]. The results of a study on Critically ill patients who were treated in the ICU with a research method using RCTs (Randomized Controlled Trials) found that patients who hospitalized in the ICU > 48 hours will experience impaired physical function and sleep disturbances [35]. Critically ill patients in the ICU with minimal mobilization, disease prognosis, unusual environment, and sedation response affect the patient's comfort

A decrease in the quality of sleep of a critical patient will increase the patient's

response muscle weakness can increase the discomfort response so that the patient's body is in a state of oxidative stress. Oxidative stress occurs because several free radicals in the body exceed the body's capacity to neutralize them. The impact of this is that the intensity of the oxidation process in normal body cells becomes higher and causes significant and more damage. Oxidative stress is the main cause, one of which is the emergence of chronic diseases such as cancer, heart disease,

Measurement of physical function can be done with several measuring instru-

TUG is a physical function measuring tool by assessing balance and the risk of falling. The tools used are a stopwatch, a chair, a meter with a minimum length of 3 meters, or 10 feet. The patient is instructed by the nurse and the patient must follow suit. The patient performs mobilization from sitting to standing and walking. The interpretation of Time up and Go (TUG) is the time taken from sitting to standing.

anxiety so that the patient is unable to be oriented and cooperative. Physical

*2.2.1 Measurement of physical function of critically ill patients in the ICU*

**52**

bed rest.

**Figure 2.**

Physical function measurement with instruments 6 Minute Test (6 MWT) to measure the patient's physical functioning endurance. The tools needed for this measurement are a stopwatch, rolling tape, aisle. The measurement carried out is the distance the patient has walked for 6 minutes [37]. The measurement is stopped if it finds the following criteria, signs, and symptoms of angina (chest pain), dizziness, confusion, ataxia, staggering, unsteadiness, pallor, cyanosis, nausea, dyspnea, fatigue, signs of peripheral circulatory insufficiency, claudication or significant pain, and the patient develops distress. Discontinue if there are hemodynamic changes such as systolic blood pressure decreases >10 mmHg, systolic blood pressure increases >250 mmHg, diastolic blood pressure rises >120 mmHg, and HR falls >15 beats per minute.
