Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 0 - 2026 02 10 1445 1445 Thandavamurthy Jayasree Department of Biomedical Engineering, College of Engineering Guindy, Anna University, Chennai – 600025, India Palchamy Pragathi Department of Optometry, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Saravanan Premkumar Department of Biomedical Engineering, College of Engineering Guindy, Anna University, Chennai- 600025, India Senthilkumar Revathi Sree Krishna Department of Biomedical Engineering, College of Engineering Guindy, Anna University, Chennai- 600025, India 2025 10 10 2026 02 10 This research introduces a novel, technology-driven approach to back pain rehabilitation by integrating real-time pose detection with interactive Unity-based gaming experiences. Our system delivers personalized exercise regimens targeting flexibility, strength, and posture while providing users with immediate feedback. User friendly gaming platform was developed using the Unity engine that integrates real-time analysis of physical exercises. The system successfully analysed the performance of three major exercises Knee-to-chest stretch (cross crunches), side bend, forward and backward bends and demonstrated a measurable improvement in the user scoring pattern, suggesting enhanced engagement and effective performance analysis. By successfully gamifying these therapeutic exercises, we aim to significantly boost user engagement and adherence to treatment protocols, leading to improved long-term spinal health outcomes. This framework offers a dynamic, adaptable, and highly scalable solution for individuals with varying rehabilitation needs, demonstrating the potential to profoundly impact the quality of life for those affected by back pain. Transforming exercises into a game is key to driving better, sustained outcomes that helps in achieving superior long-term therapeutic results. https://jmr.tums.ac.ir/index.php/jmr/article/view/1445