Abstract Persons with blindness and low vision (pBLV) experience increased fall and injury risk beyond atypical biomechanics and balance impairments. Falling risk doubles with blindness, and more than triples with depth perception losses. Despite this, physical therapy (PT) focuses on musculoskeletal injuries post-event rather than taking a proactive and preventative approach for pBLV. We posit that PT implemented pre-injury, alongside orientation and mobility (O&M) training of adapted movement protocols could positively affect injury avoidance and severity for pBLV. The global VISION 2020 initiative seeks increased access to rehabilitation services and treatments to enhance quality-of-life for pBLV. In support, this paper reviews research studies in rehabilitation science that promote physical health and wellbeing, and stresses preventative skilled mobility and therapeutic exercise to mitigate injury. To reduce the personal, financial, and societal costs associated with BLV, as well as position patients for better outcomes, we review an evidence base that may generate immediate impact in this area. While these recommendations provide an initial framework, the role of PT in pre-habilitative care remains a critical gap that must be addressed. It is imperative that interventions, guidelines, impairment/severity-specific practices, and overall health promotion are re-evaluated and redesigned for pBLV, affording equity for health and mobility.
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