Adherence to Voice Therapy Recommendations Is Associated With Preserved Employment Fitness Among Teachers With Work-Related Dysphonia

Lilah Rinsky-Halivni*, Miriam Klebanov, Yehuda Lerman, Ora Paltiel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objectives Referral to voice therapy and recommendations for voice rest and microphone use are common interventions in occupational medicine aimed at preserving the working capability of teachers with occupation-related voice problems. Research on the impact of such interventions in terms of employment is lacking. This study examined changes in fitness (ie, ability) to work of dysphonic teachers referred to an occupational clinic and evaluated employment outcomes following voice therapy, voice rest, and microphone use. Study design A historical prospective study was carried out. Methods Of 365 classroom teachers who were first referred to a regional occupational medicine clinic due to dysphonia between January 2007 and December 2012, 156 were sampled and 153 were followed-up for an average of 5 years (range 2–8). Data were collected from medical records and from interviews conducted in 2014 aimed at assessing employment status. Logistic regression models were used to assess associations between interventions and employment outcomes. Survival analyses were performed to evaluate the association between participating in voice therapy and length of retained employment fitness. Results Thirty-four (22.2%) teachers suffered declines in working capabilities due to dysphonia. Voice therapy was demonstrated as being a protective factor against such declines (odds ratio = 0.05 [0.01–0.27]). Adherence to recommendation of voice therapy was <50%. Most of the decline in working fitness among nonadherent teachers occurred within 20 months after referral. Unlike voice therapy, voice rest and microphone use were not associated with retention of working capabilities. Conclusions Voice therapy, especially when instituted early, is a strong predictor for retaining fitness for employment among dysphonic teachers.

Original languageAmerican English
Pages (from-to)386.e19-386.e26
JournalJournal of Voice
Issue number3
StatePublished - May 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017 The Voice Foundation


  • Fitness to work
  • Occupational dysphonia
  • Teachers
  • Voice disorders
  • Voice therapy


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