Discussion
irritable, pain, muscle fatigue, muscle hardness, muscle pain, disability
NECK SYNDROME, SYNDROME
The aim of the current study was to compare the effect of low-level laser, ultrasound, and exercise on pain that caused by straight neck deformity in school age children and teenagers who spent long time using electronic devices specially mobile phones (as the most used device in this age). There was a significant reduction in pain levels across all treatment groups by visual analog scale and improvement of the C shape of cervical vertebra by Cobb angle on patient X-ray, but the low-level laser therapy demonstrated the best results.In the current study, we are not only measuring the improvement of neck pain by VAS like most of the studies, but also for our known knowledge; it was the first time to use Cobb angle measured by X-ray to evaluate the improvement of the cervical curvature after treatment of LLLT, US, and exercise, so we have to demonstrate the cause of straight or text neck syndrome; the results approve that the cervical flexion angle affects the muscle fatigue of right upper trapezius muscle and left upper trapezius muscle. Healthy cervical spine has a forward convex C curve [Despite laser and ultrasound have good effects on both groups, there is a significant variation because absorption happens differently in various tissues [There are few previous studies regarding LLLT effects on muscle hardness. In agreement of our study, Gür et al. reported that 904-nm LLLT (2 J/cmAnother possibility regarding one of the most important effects underlying the mechanism of LLLT is the effect on the ATP-generating system. Karu et al. [In disagreement of our study, a study in 2020 compared LLLT with conventional physical therapy and conventional physical therapy only in reducing pain levels, improving range of motion and reducing disability scores in patients having trigger points which is a point is an irritable spot within a taught band of skeletal muscle, ligament, or fascia in trapezius upper fibers. They indicated that patients having upper trapezius trigger points benefit from traditional physiotherapy, with or without low-level laser therapy. Similar to our findings, they discovered that the two together are more efficient than physiotherapy alone at reducing pain. The two approaches had comparable effects on cervical mobility [For example, a 2017 study by Lippa et al. [Most recent studies have shown that ultrasound therapy is of poor quality. Latest evidence, however, has shown that ultrasound therapy can be utilized to deactivate trigger points associated with muscle pain syndrome. Two prior placebo-controlled investigations found that low-intensity US therapy improved pain pressure threshold and lowered sensitivity on the trigger point by producing transient effect on trigger points [In agreement of our study, Dundar et al. [Dynamic neck exercises are a type of progressive resistance exercise that targets the neck as well as other body areas. Exercises that incorporate resistance, such as isometric, isokinetic, or isotonic movements, are considered strengthening exercises. It could involve using machines for strength training, using a thera-band, free weights, or doing low-intensity endurance exercises to develop muscular control [In our study, patients received stretching and strengthening exercise which shows significant in visual analog scale and Cobb angle but was the weakest group in improvement compared with other group.The method through which stabilizing and dynamic exercises have a therapeutic effect on patients with non-specific neck pain, according to Ylinen [In a study evaluating the effects of 10 weeks of dynamic strength, endurance, and coordination exercises on pain and physical performance, Ahlgren et al. [