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Geriatrics

Ageing is autonomic decline. Falls, orthostatic hypotension, incontinence and cognitive deterioration all have an underdiagnosed autonomic nervous system (ANS) component. Supporting vagal tone and ANS balance may be the differentiating factor that reduces vulnerability, prevents hospitalisations and maintains functional independence.

Non-invasive neuromodulation with NESA XSIGNAL® supports regulation of the vagal and sympathetic circuits underlying these dysfunctions. It does not replace your clinical approach: it enhances it.

Treatment

Non-invasive neuromodulation with NESA XSIGNAL® acts directly on the autonomic nervous system, supporting processes that influence pain, tone, inflammation, microcirculation and sleep quality.

By targeting autonomic regulation, it may help reduce hyperreactivity, improve physiological variability and promote more efficient recovery between sessions.

It integrates as a supportive component within the treatment plan, without interfering with other interventions, and can be tailored to the patient’s profile: symptoms, sleep, pain, stress levels and load tolerance.

Functional objectives

  • Better sleep and more restorative rest.
  • Improved pain control and reduced hypersensitivity.
  • More efficient recovery between sessions.
  • Improved tolerance to therapy and loading.
  • Improved sympathetic/parasympathetic balance.

Applications

Common Clinical Presentations

  • Frailty, pain and sleep disturbances in older adults.
  • Sleep disorders.
  • Fatigue and reduced recovery capacity.
  • Peripheral vascular comfort: coldness, heaviness, poor perfusion.
  • Autonomic dysregulation (sympathetic/parasympathetic imbalance).
  • Cognitive fatigue and low energy.

As Support for Recovery Processes

  • Post-surgical recovery.
  • Support for microcirculation and tissue perfusion.
  • Low exercise tolerance.
  • Inflammation and edema.

Benefits

  • Improved sleep and recovery.
  • Support for pain management: acute and persistent.
  • Support for microcirculation and peripheral vascular comfort.
  • Improved tolerance to therapeutic load and exercise.
  • Complementary, non-invasive and drug-free support.
  • Individualised protocols tailored to symptoms and autonomic profile.

Modulate the root. Enhance your treatment

Neuroanatomy of the autonomic nervous system associated with your clinical specialty

IMG-012_Insula y corteza cingulada anterior
IMG-002_Amigdala y redes limbicas
IMG-030_Tronco encefalico
IMG-023_Complejo vagal
IMG-026_Nervio vago

Introducing NESA XSIGNAL®

NESA XSIGNAL® is a non-invasive neuromodulation system that applies very low-intensity microcurrents through electrodes, with protocols oriented towards regulation of the autonomic nervous system. It is designed to integrate into clinical practice as part of the multimodal approach.

In Geriatrics, the protocols act specifically on the vagal tone and autonomic balance underlying falls, orthostatic hypotension, incontinence and cognitive deterioration associated with ageing.

Testimonials

“Improving the quality of life of the elderly, especially their sleep and anxiety, has great value. NESA® brings benefits in recovery, concentration and well-being, benefiting the patient and the whole society.”
The impact of regulating the ANS in geriatrics
When specific work on the autonomic nervous system is incorporated, the effect is often systemic: reduced physiological “noise”, more consistent recovery and improved adaptive capacity. In geriatrics, this may translate into:
Supporting autonomic balance may expand the patient’s adaptive capacity, allowing local interventions such as manual therapy, exercise or procedures to be better tolerated and more consistent over time.

Key Evidence (3 papers):

  • Barkhudaryan A, et al. (2025) Autonomic dysfunction after stroke: an overview of recent advances. PMID: 40131648
  • Wu F, et al. (2022) Ocular autonomic nervous system: an update from anatomy to physiological functions. PMID: 35076641
  • Frandsen MN, et al. (2022) Preoperative heart rate variability as a predictor of perioperative outcomes: a systematic review without meta-analysis Journal of Clinical Monitoring and Computing. PMID: 35092527 DOI: 10.1007/s10877-022-00819-z
Persistent pain is associated with both autonomic dysregulation and altered central processing. Supporting autonomic regulation may help reduce hypervigilance and complement pain management strategies.

Key Evidence (3 papers):

  • Rampazo ÉP, et al. (2023) Heart rate variability in adults with chronic musculoskeletal pain: a systematic review. PMID: 37661339
  • Adlan AM, et al. (2014) Autonomic function and rheumatoid arthritis: a systematic review. PMID: 25151910
  • Barkhudaryan A, et al. (2025) Autonomic dysfunction after stroke: an overview of recent advances. PMID: 40131648
Sleep is a key modulator of pain, inflammation and tissue repair. Supporting autonomic stability may help promote more restorative sleep patterns and more consistent recovery.

Key Evidence (3 papers):

  • Chen H, et al. (2025) Association between heart rate variability and frailty in older adults: systematic review and meta-analysis. PMID: 40896980
  • Olivieri F, et al. (2024) Heart rate variability and autonomic nervous system imbalance: potential biomarkers and detectable hallmarks of aging and inflammaging Ageing Research Reviews. PMID: 39341508 DOI: 10.1016/j.arr.2024.102521
  • Tan JPH, et al. (2019) Heart rate variability as a marker of healthy ageing: a systematic review. PMID: 30104034
The autonomic nervous system regulates vascular tone and perfusion. Improved regulation may support peripheral comfort, effort tolerance and recovery processes, particularly in patients with coldness, heaviness or reduced perfusion.

Key Evidence (3 papers):

  • Lee JY, et al. (2011) Heart rate variability in men with erectile dysfunction. PMID: 21811698
  • Goernig M, et al. (2008) Peripheral arterial disease alters heart rate variability. PMID: 18684283
  • Bachmann SB, et al. (2019) A distinct role of the autonomic nervous system in modulating the function of lymphatic vessels under physiological and tumor-draining conditions Cell Reports
Integrating non-invasive neuromodulation as a supportive approach may help address the regulatory component without replacing the primary treatment. The aim is additive: greater stability, improved recovery and better adherence.

Key Evidence (3 papers):

  • Yeom JW, et al. (2025) Transcutaneous auricular vagus nerve stimulation improves sleep quality in chronic insomnia disorder: a double-blind, randomized, sham-controlled trial Sleep Medicine. PMID: 40398066 DOI: 10.1016/j.sleep.2025.106579
  • Souza R, et al. (2026) Neuromodulation of heart rate variability: a systematic review and meta-analysis Autonomic Neuroscience. PMID: 41506123 DOI: 10.1016/j.autneu.2026.103379
  • Alomari MS, et al. (2022) Non-inferior and more feasible transcutaneous tibial nerve stimulation in treating overactive bladder: a systematic review and meta-analysis International Journal of Urology. PMID: 35711082 DOI: 10.1111/iju.14961

Resources

Training courses

Our training work at NESA Academic is aimed at professionals who want to integrate non-invasive neuromodulation and autonomic nervous system regulation into rehabilitation, physiotherapy and reconditioning. The content combines physiology, application criteria by specialty, safety and session design, so that integration is practical and consistent in the clinical setting.

Testimonials

Real cases and experiences from clinics and teams that integrate NESA XSIGNAL® into rehabilitation, physiotherapy and reconditioning. What comes up repeatedly: better rest, reduced reactivity during high-load periods and more sustained treatments over time. We also share clinical meetings where protocols, learnings and case discussions are presented.

News

Articles, bibliography and downloadable materials to go deeper into non-invasive neuromodulation, autonomic nervous system, heart rate variability, vasomotor control and neurovascular health applied to rehabilitation, physiotherapy and reconditioning. A living library to keep clinical criteria up to date and provide context for each indication.