{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T19:22:40Z","timestamp":1784316160080,"version":"3.55.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>As a complex cervical spondylosis with symptoms involving multiple systems and organs, SCS is easily misdiagnosed and underdiagnosed, and there is a lack of uniform efficacy assessment criteria for SCS, which causes great distress to patients and society. In this study, we will assesse the efficacy of cervical fixed-point rotational manipulation by combining HRV-related parameters and analyzing the correlation between the HRV and SCS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods\/design<\/jats:title><jats:p>In this study, 90 participants will be randomly assigned at a 1:1:1 ratio into a test group (cervical fixed-point rotational manipulation manipulation group), a control group (sham manipulation group), or a Western medicine control group, with 30 participants in each group. All participants will be treated for a period of 4\u202fweeks. The primary outcome indicators assessed is the HRV-related parameters, and the secondary outcome indicators are the NDI scale, NPQ scale, and HAMA scale. The assessment time points will be before and after treatment. The follow-up visits will be the first and sixth months after the end of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In this study, SCS are treated with cervical fixed-point rotational manipulation based on the biomechanical balance theory, and HRV-related parameters are used for assessment to analyze the effect of cervical fixed-point rotational manipulation on heart rate variability in patients with SCS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:uri>http:\/\/itmctr.ccebtcm.org.cn\/<\/jats:uri>, identifier ITMCTR2025000569.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1634946","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T05:34:32Z","timestamp":1758864872000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of Chinese cervical fixed-point rotation manipulation on heart rate variability in patients with sympathetic cervical spondylosis based on the theory of biomechanical equilibrium: a study protocol for a randomized controlled 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