DIGNITY Collar – A Bespoke Neck Support for ALS

The project followed a human-centred and participatory design process, rooted in cross-cultural fieldwork and iterative prototyping. Initial insights were gathered through semi-structured interviews and contextual observations with clinicians, caregivers, and people with ALS in Calvary Care Bethlehem, Victoria. Multiple prototyping cycles were conducted at Monash University’s Design Health Collab using digital fabrication (parametric 3D modelling and FDM printing) and textile-making methods (WHOLEGARMENT knitting at Knovus, Melbourne and hand-stitched alternatives). Clinicians provided hands-on feedback through prototype annotation, and modifications were implemented collaboratively. The device comprises two modular components: a 3D-printed structural insert and a fabric-based collar.

The insert provides tailored support for each user’s head-drop severity and can be reprinted as symptoms evolve. The collar can be hand-sewn, machine-knit, or upcycled from breathable fabrics using a common template. A ‘kangaroo pouch’ mechanism allows the insert to be easily swaped as needs progress, and for cleaning. The final prototype was reviewed and refined in collaboration with clinical partners at Monash Health and is aligned with ALS care guidelines. Throughout the process, attention was given to aesthetics, emotional comfort, hygiene, and ease of use. The system was designed to support both formal clinical distribution and DIY/community-led production. This dual-path approach ensures it is feasible in diverse contexts without compromising on professional integrity or quality.

The DIGNITY Collar embodies design excellence by integrating functionality, aesthetics, accessibility, and adaptability. Rather than delivering a single static product, it offers a modular and personalised solution to a rapidly evolving condition. Its functionality is grounded in biomedical understanding and tailored fabrication. The structural insert is generated using parametric CAD models, enabling quick adaptation to individual needs.

These models are printable on standard FDM printers using biodegradable or skin-safe filaments such as PLA and TPU. The collar design prioritises comfort, with breathable, washable, and skin-friendly textiles. Whether professionally knitted or hand-crafted, the collar offers a dignified appearance that avoids medicalised stigma, drawing design inspiration from scarves and neckwear.

The project sets a benchmark by treating assistive devices not as clinical afterthoughts, but as personal, expressive, and evolving tools of care. It responds to the lived experience of patients and caregivers, ensuring usability, ease of cleaning, and emotional acceptability. From a quality and safety perspective, the modular system reduces full-device waste, and each component can be easily cleaned or replaced. This contributes to hygienic long-term use.

Within Victoria, the DIGNITY Collar reflects the state’s capacity to lead in inclusive design and digital health innovation. It demonstrates how design education, clinical research, and local making communities can converge to deliver professional-grade solutions with global relevance. By centring co-design and dignity, this project reframes assistive design as both socially impactful and technically excellent.

The DIGNITY Collar introduces a ground-breaking innovation in the field of progressive care. While neck braces for ALS exist, they are largely generic, off-the-shelf products. This project offers a customisable, hybrid-manufactured device that evolves with the body. Its innovation lies not in a singular novel component, but in the system architecture: a reconfigurable pairing of hard and soft elements, supported by parametric design tools and open-source fabrication methods.

This modularity enables fast reprinting as physical needs change, without requiring full replacement or expensive, specialist intervention. Aesthetically, the project takes a radical stance by refusing medicalisation. The collar draws from everyday garments, with options to personalise fabric, colour, and finish. It is an assistive device that people feel comfortable wearing in public, at home, or in clinical settings.

From a process standpoint, it represents a world-first integration of WHOLEGARMENT machine knitting and FDM 3D printing in ALS care. This dual-method production allows scalability in high-tech settings while maintaining accessibility for low-resource contexts. Clinically, the design is unique in its point-of-care compatibility: clinicians can rapidly adjust CAD files and fabricate inserts in under 4 hours, addressing time-sensitive care needs. The innovation is deeply user-driven. Participants shaped everything from insertion mechanisms to material choices, resulting in a solution that reflects real bodily and emotional considerations.

Ultimately, this project demonstrates how inclusive design, hybrid manufacturing, and open-access toolkits can create dignified, localised interventions for global health challenges.

The DIGNITY Collar’s impact is visible across social, clinical, environmental, and design systems. Socially, it restores agency and dignity for people with ALS. Rather than adapting the body to rigid technologies, it adapts the device to changing bodies. Users can customise and feel ownership over their support device, enhancing comfort, confidence, and continued use.

Clinically, the design fills a critical procurement gap. Traditional assistive devices for ALS often arrive too late or don’t fit. This system can be fabricated at the point-of-care within hours, reducing delays, clinical backlogs, and resource strain. It fits easily into allied health workflows and supports iterative use over time. Environmentally, the design reduces waste. Instead of discarding entire units, only the 3D insert needs to be updated, and this is made of a single recyclable material. The textile collar is reusable and washable, extending lifespan and lowering material use. Fabric options include repurposed and natural fibres, and printing filaments are biodegradable or recyclable. E

conomically, the device costs under AUD $30 in materials and under $10 in local labour when produced through community networks or clinical makerspaces. This affordability makes it accessible for users and sustainable for institutions. The project also promotes open, participatory systems of design and care. Its template-based approach enables others, such as students, clinicians, and caregivers, to adapt or improve it. In doing so, it contributes to a growing culture of health innovation rooted in Victoria.

By showcasing what is possible when professional design is embedded in healthcare futures, the DIGNITY Collar exemplifies the value of investing in local design capabilities and ethical innovation.

The DIGNITY Collar embodies circular design principles by separating structure from comfort, enabling modular repair, reuse, and adaptation across the product lifecycle. Designed for people with ALS experiencing Dropped Head Syndrome, the collar is built from two core components: a parametric 3D-printed insert and a soft textile collar. These elements are deliberately decoupled to allow for targeted updates—rather than replacing the entire device when symptoms evolve, users or clinicians can simply reprint the insert using updated anatomical data. Material selection prioritises circularity and low environmental impact.

The 3D-printed components are fabricated using PLA or TPU, both recyclable polymers suitable for skin contact. The collar’s textile housing is made from breathable, washable fabrics such as cotton, bamboo, or locally upcycled cloth, all of which support hygiene and extended use. In high-tech contexts, collars are knit on WHOLEGARMENT machines, producing seamless forms with zero yarn waste. In lower-resource settings, hand-crafted or stitched versions use minimal materials and can be made from surplus or scrap textiles.

The project encourages local, decentralised production, reducing emissions associated with centralised manufacturing and global logistics. Its open-source digital templates enable communities and care centres to produce or repair the product on-site using accessible tools such as desktop 3D printers and basic sewing equipment. This localisation of production aligns with circular economy goals by keeping value in the local system and minimising transportation waste. At the end-of-life, each component can be separated for material-specific recycling or composting. This disassemblability supports post-use recovery and promotes product stewardship among users and makers.

Overall, the DIGNITY Collar demonstrates how circular thinking can be embedded into healthcare design, enabling both sustainable material practices and resilient systems of care, while responding compassionately to the needs of people living with progressive disabilities.