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Introduction and objectives Individuals with respiratory disease often display reduced exercise capacity, which is also observed in other long-term conditions (LTCs), including coronary heart disease, heart failure, and chronic kidney disease. In patients with multiple long-term conditions (MLTC)—defined as the presence of two or more LTCs—the interaction of these conditions may compound functional impairment. This study aims to investigate the relationship between MLTC profiles and exercise tolerance, measured by the Incremental Shuttle Walk Test (ISWT), in patients enrolled in Pulmonary Rehabilitation (PR).Methods Data was collected from the PR service at Glenfield Hospital, Leicester (Jan-Nov 2024). Two statistical models were employed. First, a linear regression model assessed the association between the number of LTCs and baseline maximal ISWT distance, adjusting for age. Second, a Gaussian Mixture Model (Latent class analysis) was used to identify distinct MLTC profiles based on posterior probabilities of conditions included in the classes. These class memberships were included in a follow-up regression model predicting ISWT distance.Results 379 patients (67.1±10.8 years old, 51.5% female, 4.7±2.25 LTCs) were included in the models. Linear regression indicated that each additional LTC was associated with a significant reduction in ISWT distance of-16 metres (p < 0.001), alongside a significant age-related decline of -3.21 metres per year (p < 0.001).A five-class model was identified from latent class analysis, yielding clusters labelled as: ‘COPD+’, ‘ILD+’ (Interstitial lung disease), Respiratory Psychosomatic (Anxiety & Depression), Respiratory Cardiometabolic, and Respiratory Musculoskeletal Cardiometabolic. Compared to the single morbid reference group, the Respiratory Cardiometabolic (-84 meters; p = 0.04) and Respiratory Musculo Skeletal Cardiometabolic (-133 meters; p = 0.008) classes showed significantly lower ISWT distance, alongside a significant age-related decline of -3.54 metres per year (p < 0.001).Abstract S140 Figure 1Conclusions These findings support the hypothesis that both the number and specific combinations of MLTCs significantly influence exercise capacity in this cohort of patients enrolled in PR, with potential implications for personalised management and rehabilitation planning.