PURPOSE: A systematic literature review to evaluate the effectiveness of direct and/or indirect vocal interventions in preventing voice disorders in teachers. SEARCH STRATEGY: We searched for articles from January 1980 to April 2013 in the following electronic databases: MEDLINE (accessed via Pub Med), Pub Med, LILACS, SciELo, Scopus, and Web of Science (WoS). SELECTION CRITERIA: We included randomized controlled trials that had evaluation of interventions in teachers as their main objective. We excluded articles that reported subjects with vocal pathologies. DATA ANALYSIS: As a result of the initial search, 677 studies were identified, 5 of which met the inclusion criteria. Four other articles cited by the studies that had the full text available were added to these. RESULTS: Combined direct and indirect intervention was reported as the best methodology for preventing voice disorders in teachers. The studies included in this review indicated improvement after interventions, often over a short period of time. In other studies, whose focus was the comparison between combined and isolated interventions (direct/indirect), it was observed that isolated interventions did not lead to significant improvement, despite improvements in some isolated vocal parameters. CONCLUSION: Combined direct and indirect vocal intervention is associated with more significant improvement than either intervention alone.
