The kaośikii dance involves rhythmic symmetrical movements of both sides of the body and as such muscles on both sides of the body are worked equally. Central to the execution of this dance from the mechanical viewpoint is the platforms that are being offered by the muscles surrounding the lumbopelvic region and the neck. Platforms infer that there exists a stable base provided by the contraction of the muscles in these regions. Once the platforms are in place, the upper and lower extremities will be able to perform the respective movements more efficiently and effectively.

                  a                         b                   c             d                         e                         f

                                                                  Fig 1

The dance begins with the arms in elevation (fig 1) and they remain mostly in elevation throughout the dance. The shoulder blades (scapulae) which are seated on the back of the rib cage will have to be rotated outward on the cage in order to fit the position of the raised arm. Since there is no movement of the arms, the scapular muscles are working isometrically (holding contraction) and by nature of this type of contraction will help increase the endurance of the muscles. These muscles are the trapezius and serratus anterior (fig.2). In Kaośikii the trapezius muscle particularly the upper portion (upper trapezius) which has connection to the neck via its attachments are contracted bilaterally and because of this, exert an equal bilateral pull on the cervical spine. This helps to stabilize the cervical spine as opposed to a unilateral pull which tends to rotate the cervical spine slightly to the same side.

 Fig 2 muscles around the shoulder girdle

In addition, arm elevation clearly aids in the extension of the thoracic spine (upper - mid back) which helps to counter the age-related structural changes in the thoracic spine as in kyphosis (rounded upper back). Thoracic extension is also enhanced by the fact that the interscapular muscles called the rhomboids (fig 2) are in a mechanical advantaged position to work as thoracic extensors particularly during the second part of the dance (fig 5). The pectoral muscles (fig 3) will be nicely stretched out during arm elevation and as is the case when the trunk is going through extension into hyperextension.

Apart from the scapula, there are muscles attaching the head of the upper arm (humeral head) to the shoulder blades (scapulo - humeral muscles). These muscles move the arm in within the joint. The deltoid muscle (fig 2) which moves the arms up from the sides will remain in isometric contraction for as long as the arms remain elevated. With the shoulder blades being stabilized by the trapezius and serratus anterior muscles as discussed above, another scapulo - humeral muscle group called the rotator cuff (they run transversely across the shoulder joint - Fig.4) will work to stabilize the shoulder joint in its ideal position by helping to keep the head in a downward rotated position. Any movement impairment of the scapula will affect the ideal joint positioning and lead to faulty mechanics of the rotator cuff. For a person with rotator cuff tendinosis / tendonitis, arm elevation would be a painful maneuver to do. Additionally, if the muscles of the shoulder blades are not working properly due to weakness, shortening or imprecise timing in its activation, some other muscles will start to take over and overload the neck since the neck is closely related to the shoulder girdle due to some muscular attachments that connect between the two (see fig 2)

                                                  

Fig 3 Pectoral muscles                                                            Fig 4 Rotator cuff muscles across the shoulder joint

As mentioned before the platform is an important mechanism. Take for example a tent which is held up by a central pole and some guide ropes. The central pole is likened to the stabilizers of the neck and the guide ropes are the mobilizers. Without the stabilizers the tent will not stand up optimally. The stabilizers are unique in that they attach only from one vertebra to the next. Hence its contract ion is only to provide stability. The mobilizers traverse over several segments and when they contract will bring the two ends of its attachments closer together. Working together they provide a mechanism that will protect the joints during gross movements. Demonstrating this mechanism, during side bending of the body to the right (fig 1 (a) - (d)), the left neck side flexors are contracting while going into forward bend (fig 5 (a) - (b)) the neck extensors are contracting to counter gravity. They continue to work until the trunk is upright again (fig 5 (b) - (c)).  From the upright posture through to hyperextension of the trunk (fig 5 (c) - (e)), the neck flexors will work strongly to keep the head aligned with the rest of the spinal column during the dance. So, in Kaośikii the deep neck flexors are called in to stabilize segmentally at the same time the mobilizers of the neck are working to execute the gross movements of the neck.

               a                         b                      c                            d                         e

                                                                  Fig 5

As a precaution, it would not be advisable to perform this dance when there is any instability in the neck. Vertigo and dizziness will have to be checked and cleared first as it may mask an underlying "RED FLAG" condition since extension is particularly vulnerable for the neck with these conditions.

In the rib cage / thoracic region, the compression and opening up of the rib cage during forward and backward bending respectively as well as lateral bending which causes the ribs on the concave side to come together and those on the convex side to separate, provide a high degree of rib cage mobilization which in turn enhance the mechanics of respiration. In the mid region adjacent to the thoracic spine lies a respiratory reflex zone that when stimulated will improve rib cage expansion during respiration.

It is also worth mentioning that the major lymph nodes of the upper extremities are found in the underlying connective tissue of the arm pit. Somatic dysfunction affecting the venous return (blood from the vein system) from the upper limb back into the upper thorax region may also be impaired. So it would appear that movements occurring at the upper extremities / thorax region would mobilize such connective tissues / structures.

During the first phase of the dance the movement (fig 1) is that of sequential side bending of the vertebral column. The left paraspinal muscles (fig 6) as well as the lateral trunk flexors (fig 7) which are occupying the spaces between the bottom end of the rib cage and the pelvis on the sides, work in a lengthening or what is termed "eccentric" contraction in stages to effect the side bending movement. On return from side bending they work in a shortening or "concentric" contraction against gravity in stages. The eccentric and concentric contractions will invariably cause an increased local blood flow to these muscles aiding the stretching out of these muscles. Since it is done in stages, the release will be more gradual as the muscles can adapt neurally via the reflex loop.

Deep back muscles

Paraspinal muscles

Hip abductor

Fig 6 muscles of the back

       (From Kendall & Kendall: Muscles testing & Function, 3^rd ed., Williams & Wilkins, 1983)

The second phase of the dance (fig 5) involves forward and backward bending of the spinal column. The paraspinal muscles of the spine will go through a lengthening contraction to lower the trunk forward. There is a backward translation of the hips as the trunk flexes forward to maintain the body's centre of mass over the feet. Fig 8 shows the pelvic musculature and their relation to one another as they function to check or guide the lumbopelvic region by way of counterbalancing the forces of forward bending of the trunk to prevent falling over. On the stance leg i.e. the leg which has its foot flat on the ground the muscles on the front part of the lower leg (shank) work strongly to resist the backward displacement of the shank while the front thigh muscles will work to maintain knee extension. The muscles of the back and back of the thigh (of the stance leg) will be stretched

Lateral trunk muscles

                                                                                                Fig 7

              (From Kendall & Kendall: Muscles testing & Function, 3^rd ed., Williams & Wilkins, 1983)

Returning from the forward bent position (fig 5 (b) - (c)), initially the hip extensors will kick in to extend the hip and thereafter will continue to do so concurrently with the paraspinal / back muscles. The back muscles will contract to extend the trunk but it is the thoracic paraspinal / extensors that induce a majority of torque to extend the thoracic cage on the pelvis. From the upright posture going into trunk hyperextension (fig 5 (c) - (e)), there is a strong stretch and contraction of the front abdominal muscle which runs vertically down from the sternum to the pubic symphysis (rectus abdominus) (Fig 9). Trunk extension is coupled with knee flexion which serves to maintain the body's centre of mass over the feet. The calf (fig 7) and hamstring muscles (fig 8) will be active in this case.

In lumbar extension, the back part of the vertebrae will approximate while the front portion there will be a distraction of the bony parts (fig 10). In an unstable lumbar spondylolisthesis where there is a forward translation of one vertebra on the other, lumbar extension will only make it worse. In spinal stenosis as depicted by a narrowing of the spinal canal lumbar extension will further minimize the space. As such, these conditions are contraindicated in back extension movements. It can potentially cause numbness or paralysis to the lower limbs. As for cases of non specific low back pain without spinal instability, then there is no harm with performing kaośikii, but the platforms need to be worked on. The subject will most likely experience a lingering ache.

Gluteus maximus

Hip abductors

Hamstrings

                                                                                                                                                           

Fig8 pelvic musculature                                                                                    

From Porterfield & De Rosa, Mechanical low back pain, 1991, WB Saunders

back

front

Rectus abdominus

                                                                   

            Fig 9                                                                 Fig 10 Lumbar vertebrae extension

Interestingly, the "posterior oblique sling" (fig 11) is activated during extension of the spine when both arms are elevated and held together. The posterior oblique sling is energized by the coupled action of latissismus dorsi and gluteus maximus (seat muscle) of the opposite side. This contraction can directly optimize the stabilization of the pelvic girdle. The latissismus dorsi is a postural muscle and therefore like most postural muscles have the tendency to shorten. In Kaośikii, this large important muscle will be stretched.

Latissismus dorsi

Gluteus maximus

Fig 11 Back view - posterior sling

                       

The lumbopelvic girdle platform is activated throughout the whole sequence of the dance. Using the tent as an example, the central pole is represented by the deep muscles of the back coupled with the transversus abdominus which wraps around the pelvis like girdle. It is reported that the deep structures offer only 10% stability while the mobilizers 90% but without this 10%, the lumbar spine will "crumble".

There is a rhythmical alternate stamping of the ball of the foot during the dance which means that momentarily there is an alternate single leg stance period. The major muscle group that is active in the stance leg will be the lateral hip muscle group involving the hip abductors. Its purpose is to stabilize the pelvis thus preventing a drop of the pelvis on the opposite side. The seat muscle and its opposing group of front thigh muscles will co-contract to maintain the hip joint in erect posture as and when demanded by the dance. The flexors of the toes together with the calf muscles will work strongly to maintain the lower leg over the ankle.