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A collaboration between a fashion designer and a Senior Lecturer in Medical Sociology in the Department of Academic Rheumatology at King's, Garment+ tests the role of fashion as a vehicle for positive well-being in patients with musculoskeletal conditions.

GarmentplusFashion plays an important part of people's lives and contributes to their sense of identity. This is no less true for people living with long-term musculoskeletal conditions (MSK), such as Rheumatoid Arthritis, who often have difficulty dressing due to pain, stiffness, fatigue, and restricted joint mobility. Yet clothing is not always tailored to a variety of bodies and physical capabilities. Existing studies have shown that people with MSK conditions believe that accommodative fashion underscores the notion of ‘illness’ as its aesthetics are often not compatible with their everyday lives.

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Garment+ summative exhibition installation shot, courtesy of Dr Heidi Lempp and Alexa Chan

Garment+ posited clothing as a complementary tool for the support of patient well-being. Despite clothing’s intimacy with the human body, mainstream garments marginalise a significant proportion of the population (there were an estimated 11.6 million disabled people in the UK in 2014). These people are most in need of a strengthened sense of self by disregarding the ergonomics necessary for greater ease of dress, comfort, independence  and movement. Furthermore, the aesthetics of existing adaptive clothing further perpetuate the stigma of living with a visible or non-visible long-term illness, which can result in feelings of frustration and social exclusion.

In an attempt to remedy this, designer Alexa Chan, a graduate of London College of Fashion, and Dr Heidi Lempp, Senior Lecturer in Medical Sociology, worked with a group of patients to co-create new garment designs that are mobility-friendly. 

Find out more about accommodative fashion in this interview with Alexa about her work.

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Garment+ summative exhibition installation shot, courtesy of Dr Heidi Lempp and Alexa Chan

The patients were invited to test garment prototypes during workshops and their daily activities. Through four co-design workshops, design parameters were determined through an iterative cycle of making, testing, feedback and modification. This practice allowed for the development of a range of template designs that overcome the different barriers to independent dressing and wider diversity of choice. The resulting prototypes reflected patient concerns regarding garment closures, comfortable fabrics and proportions. Patients concurred that garments that are functional, accessible and aesthetically compatible with their daily lives can maximise patients’ satisfaction, independence and social acceptance; thus playing a pivotal role in sustaining a feeling of control over their personal lives.

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Garment+ summative exhibition installation shot, courtesy of Dr Heidi Lempp and Alexa Chan

Patients’ experiences were collated and used to further research practices in the fields of both clothing design and patient care. Allied health professionals and carers will then be able to use the project’s findings to guide and support people with MSK conditions in making early lifestyle adjustments, rather than leaving the patient to trial-and-error, therefore minimising frustration about their physical restrictions. The project also sought to produce an educational ‘toolkit’ for designers that can be applied in teaching to encourage fashion students to consider often overlooked body types and capabilities, without compromising aesthetic inclinations. 

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Garment+ summative exhibition installation shot, courtesy of Dr Heidi Lempp and Alexa Chan

Project events

The work of the project team and their patient group was showcased in two events:

13 December 2016 - a one day showcase in Golden Jubilee Wing Atrium, Denmark Hill Campus, King's College Hospital.

24–25 February 2017 - a two-day exhibition in Guy's Hospital Atrium 1, Guy's Campus. King's College London.

This summative exhibition chronicled the collaborative design, research journey, findings and outcomes yielded from the project. 

Alexa was available for questions and discussion and gave project walk-throughs on both days.

170224-25 garment+ exhibition leaflet (updated final)

Project outputs

Prior to the commencement of the funded project, Alexa and Heidi presented a poster from the first phase (Alexa’s MSc project) during the annual 2016 EULAR (European League against Rheumatism)  Congress in London. This was an important formative phase for Garment+, without which the second phase would have not happened.

At the end of the first phase, Alexa also presented her work during one of the Department of Academic Rheumatology's organised Patient Education Evenings, where her presentation was received with great enthusiasm by the attendees.

Following the completion of the funded project she presented her work again during another Patient Education Evening. Both evenings were formally very well evaluated.

The project has been featured in the National Rheumatoid Arthritis Society magazine and the team presented their findings at national conferences (British Society of Rheumatology, 25–27 April 2017 & Association of Dress Historians, 27–28 October 2017) and internal events with physio/occupational therapists and patients within King’s College Hospital. The team is also hoping to develop an educational garment toolkit with the London College of Fashion and potentially extend the research of design parameters to adolescent patients.

Heidi and Alexa's joint paper: Chan, A & Lempp H (contributing authors: Peabody G. Simpson C. de Souza S. Galloway J. Milasevic M. Prout J. Ellam I. Esterine  A. GillingwaterE.) Garment +: Challenging the Boundaries of Fashion for those with long–term physical disabilities. (Journal of Dress History, in press) will be published middle of June 2018.

Project team

Dr Heidi Lempp, Senior Lecturer in Medical Sociology, Department of Academic Rheumatology

Alexa Chan, MA Fashion Futures Graduate, London College of Fashion, University of the Arts London. 

The project team also includes Dr James Galloway, Senior Clinical Lecturer/Consultant in Rheumatology, two departmental Expert Patients, and one Outpatient Clinic patient.


Garment+ is a collaboration between King's College London's Department of Academic Rheumatology and designer Alexa Chan, brokered and supported by the Culture Team at King’s College London.

Arts, Health and Wellbeing Programme
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