Intervenções vocais diretas e indiretas em professores: revisão sistemática da literatura

Abstract

Purpose: The aim of this work is to verify the efficacy of direct and indirect vocal interventions in preventing voice disorders, with specific and combined strategies, by a systematic review of the literature.Research strategies: Articles published from January, 1980 to April, 2013 were searched in the electronic databases MEDLINE (accessed through PubMed), PubMed, LILACS, SciELO, Scopus and Web of Science. Selection criteria: All the articles that presented randomized controlled studies with some type of vocal intervention with teachers as their primary aim were included. Articles that presented subjects with larynx and voice alterations were excluded. Results: As a result of the initial search, 677 studies were identified, five of which followed the inclusion criteria. Four more articles, found in the references of the studies selected for reading of the full text, were included. Conclusion:The combined intervention (direct and indirect) presented a significant improvement in vocal quality parameters and self-assessment, even in a short period of time. In other studies, which focused on the comparison between combined and specific interventions (direct or indirect), no differences were observed, although improvements in some of the assessed vocal parameters were described. A limitation of this review is the restriction of the methodological design of the studies, including only randomized clinical trials. The combined vocal intervention presented more significant results than the specific intervention. apresentou melhora significativa em parâmetros da qualidade vocal e na autoavaliação da voz, mesmo em curto período de tempo. Em outros estudos, cujo foco era a comparação entre a intervenção combinada e intervenções isoladas (direta ou indireta), não foram observadas diferenças significativas, apesar de serem descritas melhoras em alguns dos parâ-metros vocais avaliados. Como limitação desta revisão, pode-se incluir a restrição quanto ao desenho metodológico dos estudos, incluindo apenas ensaios clínicos randomizados. A intervenção vocal combinada apresenta resultados mais expressivos do que a intervenção isolada.

Effect of direct and indirect voice training in Speech-Language Pathology and Audiology students

“…In short, direct approach training, consisting of vocal exercises, can provide a change in vocal functioning (8) , with reduced vocal intensity and increased fundamental frequency (6) ; expansion of frequency range with better range of low and high sounds, and vocal intensity with better range of weak and strong sounds (10) ; better articulation pattern and fluency of speech (11) ; and reduced jitter (12) . However, the indirect approach can help the individual to understand vocal use (8) and prevent worsening of vocal symptoms (12) .…”

“…According to the literature (8,9) , there are three main approaches to improving the communication patterns that can prevent voice problems: direct approach, consisting of vocal exercises; indirect approach, consisting of vocal hygiene guidelines; and combined interventions (direct and indirect approaches).…”

Aquecimento e desaquecimento vocais: revisão sistemática

“…The actions that seek to promote vocal health of voice professionals can be of two types, direct or indirect 1 . The indirect approach helps the subject to understand the vocal use and to develop strategies that might minimize the risk factors, by developing actions towards the guidance on vocal health that seek to reduce the incorrect use of the voice.…”

“…The indirect approach helps the subject to understand the vocal use and to develop strategies that might minimize the risk factors, by developing actions towards the guidance on vocal health that seek to reduce the incorrect use of the voice. The direct approach provides a change of vocal functioning, by offering some instruction techniques for voice, in order to encourage an efficient vocal production, and they usually involve the practice of vocal warm-up and cool-down programs 1 .…”

“…The vocal warm-up aims to increase the blood flow, the oxygenation and the flexibility of tendons, ligaments and muscles, which allows greater glottal closure, increased flexibility of the vocal folds to proper stretching and shortening during frequency variations, vocal quality with higher component harmonic, increased sound pressure level (SPL) and improved vocal projection and articulation of sounds [1][2][3][4] . The cool-down, on the other hand, aims at the return to the regular muscular adjustments of the speaking voice, decreasing the blood flow and promoting the return of lactic acid, thereby preventing muscle fatigue 5 .…”