Patients with complete high cervical spinal cord injury have significantly restricted social participation even with the use of various prosthetic devices. We describe a patient with a C5 complete injury who showed remarkable improvements in social participation after obtaining a service dog.

During March X-8, a 48-year-old man experienced a C5 complete spinal cord injury and underwent anterior cervical fusion. In January X-7, he underwent cystostomy. He discharged from the hospital in September with Zancolli classification: C5A and American Spinal Injury Association Classification: A. Since living with his service dog, he has been giving lectures about his experiences and opinions regarding physical disabilities and barrier-free-concepts at medical institutions and schools. In October X-2, he successfully flew from Ishikawa Prefecture to Tokyo with his service dog. He received the Ishikawa Prefectural Barrier-free Governor Prize. In July X, a semi-structured interview was conducted using the International Classification of Functioning, Disability, and Health (ICF) Rehabilitation Set. The interview and analysis were performed after obtaining written consent. The ethics committee of our institution permitted this study. There are no conflicts of interest.

Using a service dog positively changed the man's health condition as defined by ICF. The following outcomes were observed: ability to take initiative and focus on actions, increased motivation, clearer planning for specific care needs, physical improvement, increased resilience, increased physical movements, emergence of new roles, better ability to resolve emotional conflict, improved autonomous health management, locomotion with a service dog, communication facilitation, acquisition of stress coping measures, living with consideration of other people, acquiring a job, employment, experiencing positive emotions, reduction of psychological barrier, increased social support and empathy due to visualization of disability, assistance from public service providers (Fig. 1).

Service dogs can encourage social participation, even for those with a complete high cervical spinal cord injury.