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Methods and analysis 60-patient parallel group pilot RCT in 7 Canadian medical-surgical ICUs. We will include all previously ambulatory adult patients within the first 0–4 days of mechanical ventilation, without exclusion criteria. After informed consent, patients will be randomised using a web-based, centralised electronic system, to 30 min of in-bed leg cycling in addition to routine physiotherapy, 5 days per week, for the duration of their ICU stay (28 days maximum) or routine physiotherapy alone.

We will measure patients' muscle strength (Medical Research Council Sum Score, quadriceps force) and function (Physical Function in ICU Test (scored), 30 s sit-to-stand, 2 min walk test) at ICU awakening, ICU discharge and hospital discharge. Our 4 feasibility outcomes are: (1) patient accrual of 1–2 patients per month per centre, (2) protocol violation rate 80% at the 3 time points and (4) blinded outcomes ascertainment >80% at hospital discharge. Hospital outcome assessors are blinded to group assignment, whereas participants, ICU physiotherapists, ICU caregivers, research coordinators and ICU outcome assessors are not blinded to group assignment. We will analyse feasibility outcomes with descriptive statistics. Introduction Surviving critical care is the first step in a long road of physical, cognitive and psychological recovery.

While medical advances have reduced the mortality of critical illness, survival comes with substantial residual physical burdens and societal cost. Intensive care unit (ICU) survivors are at risk of important mobility impairments posthospital discharge. At 1-year follow-up, 34% of patients surviving their stay in the ICU were below sex-expected and age-expected norms for the 6 min walk test (6MWT), and 51% had not returned to work. Although early rehabilitation would benefit survivors if their physical function or quality of life could be improved, critically ill mechanically ventilated (MV) patients are often perceived as ‘too sick’ for physiotherapy (PT). Rehabilitation in the ICU can be infrequent (eg. Recruitment and randomisation Enrolment began in March 2015, and is anticipated to continue until December 2016. In each centre, an ICU research coordinator will screen the ICU census regularly to identify patients who meet study criteria and will seek written informed consent from patients or their substitute decision makers before randomisation.

Once patients are alert, they will be evaluated for capacity and consented for continuation in the trial. We will use a centralised web-based, secure randomisation service for clinical trials (). Following consent, the research coordinator will log in to the website, register the patient and receive the randomised assignment. We will stratify by centre, medical versus surgical admission status and age ≥65.

Procedures presents the planned flow of participants throughout the study. Individual patients will receive the randomised intervention 5 days per week (excluding weekends and statutory holidays), for the duration of their index ICU stay (maximum 28 days, whichever occurs first) from ICU physiotherapists as part of their normal role. After 28 days, all patients remaining in the ICU will receive routine PT per institutional standards. Those randomised to routine PT will not receive in-bed cycling.

We will conduct outcome assessments at ICU awakening, ICU discharge and hospital discharge (described further below). During PT sessions, physiotherapists will screen participants for readiness for awakening assessments, and will initiate their strength and function assessment once patients successfully answer ≥3/5 standardised questions per previous studies (open (close) your eyes; look at me; open your mouth and stick out your tongue; nod your head; raise your eyebrows when I have counted up to 5).

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Experimental Patients will receive 30 min of in-bed cycling in addition to routine PT, for the duration of their index ICU stay (maximum of 28 days or when able to march on the spot for 2 consecutive days with assistance, whichever occurs first). We chose to discontinue cycling after marching on the spot for 2 days to allow physiotherapists and patients to focus on progressing mobility and ambulation activities. During in-bed cycling, patients will be positioned semirecumbently as per ventilator-associated pneumonia prevention guidelines. We will use a specialised in-bed cycle ergometer (eg, RT300 supine cycle), which provides three possible cycling modes: passive (ie, no patient initiation), active-assisted (ie, partially initiated by the patient) or active (ie, fully initiated by the patient).

Our aim is for participants to complete as much active cycling as possible during each 30 min session. Each patient will receive a pre-programmed standardised treatment template. Each session will start with a 1 min motor-driven passive cycling warm-up at a rate of 5 revolutions per minute (RPM). We chose 5 RPM based on clinical experience with comatose patients who demonstrated some active cycling above the set motor rate.

Patients will continue with passive, active-assisted or active cycling for the next 29 min, according to their level of participation. The session will finish with a 30 s motor-driven cool-down (30:30 total). Since ICU patients' level of consciousness may vary throughout their stay, we will allow patients to cycle at a self-selected RPM and will not change the resistance. If the patients stop cycling actively, the ergometer will revert to passive cycling. Therapists will titrate the motor speed to provide sufficient support to promote as much active cycling as possible. Because of the dynamic nature of critical illness, we will screen participants daily for criteria precluding in-bed cycling (). For example, we will not cycle on a day where a patient has cardiac or respiratory instability, active major bleeding, or severe agitation.

During every cycling session, patients will be carefully monitored for safety and indications for termination of cycling, including signs of cardiac or respiratory instability, and catheter or tube dislodgement. We will record vital signs (eg, heart rate), physiological parameters (eg, minute ventilation) and cycling achievements (eg, active cycling, distance) every session. Outlines cycling session termination criteria. For centres with no experience with in-bed cycling or with the study bike, we will provide all ICU PTs with a 1-day (approximately 8 h) training session on use of the in-bed cycle ergometer from the study PI (MEK) and equipment vendor. This training session includes didactic lectures and use of the cycle with both simulated and critically ill patients.

The PTs receive a binder including key ICU rehabilitation trials, specialised ICU bike instruction manuals, a laminated bike quick start pocket card and a computer tablet in a military-grade protective case compliant with hospital infection-control requirements preloaded with electronic versions of all paper materials. Centres will gain clinical experience with routine use of the in-bed cycle with critically ill patients before enrolling patients in the CYCLE pilot RCT. All PTs will receive in-service training on the in-bed biking protocol. At each site, we will train multiple PTs to bike to ensure a trained therapist is always available despite vacation time or unplanned absences. The Methods Centre will also assist each site with trouble-shooting equipment problems and outcome measure questions.

Control: routine PT Patients will receive routine PT per current institutional practice as part of their normal role. Routine PT may include activities to assist with optimising airway clearance and respiratory function, and, based on the patient's alertness and medical stability, activities to maintain or increase limb range of motion and strength, in and out of bed mobility, and ambulation.

We expect some interinstitutional variation in routine PT interventions. To date, there are no Canadian data documenting routine PT interventions; two point prevalence studies and a multicentre prospective cohort study documented inconsistent mobilisation practices in different countries, across centres. We will use the same criteria to terminate routine PT sessions (). Outcome measures The four feasibility outcomes are outlined above. Teenage Mutant Ninja Turtles 2003 Download Full Pc Game Tpb there.

Below, we describe the planned primary and secondary outcome measures for the full CYCLE RCT. We will measure all of the outcomes described below in the CYCLE pilot RCT. Outcome measures for the full CYCLE RCT: The primary outcome for the full RCT will be the Physical Function ICU Test—scored (PFIT-s) measured at hospital discharge.

It is a reliable and valid four-item scale (arm and leg strength, ability to stand, and step cadence) with a score range from 0 to 10 (higher scores=better function). We chose the PFIT-s because we expect all ICU patients will be able to complete part of the assessment even if they cannot stand (eg, arm or leg strength), limiting floor effects, and its strong psychometric properties (reliability intraclass correlation coefficient range=0.996–1.00; convergent validity with the 6MWT and manual muscle strength testing ). Secondary outcomes in the full CYCLE RCT include muscle strength (Medical Research Council manual muscle strength, quadriceps strength ) and function (eg, 30 s sit-to-stand, and 2 min walk test). These measures have normative values, good reliability in critically ill or frail elderly populations and are included in other ongoing ICU rehabilitation studies. We will also collect hospital discharge location, frailty, length of MV, LOS (ICU, hospital) and mortality (ICU, hospital), patients' perception of physical function, Katz activities of daily living (ADLs) scale, critical care-related psychological distress (Intensive Care Psychological Assessment Tool (IPAT) ), and health-related quality of life (EQ-5DL). Describes the outcome measures.

Description of outcome measures for the CYCLE pilot and full RCT We will follow all patients throughout their ICU and hospital stay until death, transfer to another hospital or hospital discharge. At each site, a research coordinator will track each patient's location in hospital and liaise with hospital staff to identify anticipated hospital discharge date.

At ICU discharge and at hospital discharge, the research coordinator will assess patients' perceptions of physical function, Katz ADL scale, IPAT and EQ-5DL. All strength and physical function outcome assessors will receive a 3 h in-person training session and support materials.

At each site, we will train multiple assessors to ensure a blinded outcomes assessor is always available despite planned or unplanned absences. This interactive training session includes didactic lectures, and use of the strength and physical function outcome measures with simulated patients. The PTs will receive paper copies of each outcome measure, administration instructions and normative values (where available). Harms We expect few risks to the safety of participants involved in either arm of the CYCLE Pilot RCT. Routine PT in the ICU, including in-bed cycling, is safe. A comprehensive review of 2.5 years of PT in a critical care rehabilitation programme in 1110 patients and over 5267 rehabilitation sessions identified physiological abnormalities or potential adverse events in 2.5 per 1000 patients and 6 per 1000 therapy sessions, respectively.

Of these, patients received 628 in-bed cycling sessions as part of routine PT, and experienced 1 safety event (1.6 safety events per 1000 PT treatment days). In a focused retrospective review of a subset of the critical care rehabilitation programme described above, of 541 cycling sessions, patients experienced one radial arterial catheter dislodgement, no unplanned extubations and no predefined cardiorespiratory physiological abnormalities.

Authors reported no catheter or tube dislodgements in six ICU cycling studies. Similarly, in the RCT of cycling started 2 weeks into the patient's ICU stay, no severe physiological adverse events occurred (eg, arrhythmias, myocardial ischaemia); 16 sessions (4%) stopped early due to low oxygen saturation (180 mm Hg; n=6, >20% decrease in diastolic; n=2); all variables returned to baseline within 2 min of activity cessation. Three patients in the cycling group withdrew: two due to cardiac instability, and one due to an Achilles tendon rupture. Outlines termination criteria and safety events recorded in the CYCLE pilot RCT. We will also record the consequences of the safety events. Blinding Given the nature of the intervention, patients, ICU PTs, ICU caregivers, family members and research coordinators will not be blinded to intervention allocation.

However, outcomes assessors will be blinded to the allocation, as they will be assessed by a core group of PTs who did not care for patients in the ICU. We will ask patients and their family members not to disclose the patient's assigned treatment to PTs involved in assessing hospital outcomes to protect against performance bias.

Data collection, management and analysis plan In both groups, we will collect baseline data including patient demographics, ICU admission reason, medical versus surgical status, severity of illness, comorbidity and prehospital function. ICU-related variables captured daily during the patient's ICU stay will include illness severity, other life supports, drug exposure and nutrition. We will collect relevant cointerventions that may impair patient function, including receipt of corticosteroids and neuromuscular blocking agents, and duration of bed rest. We will also record the type and duration of all PT interventions (eg, passive or active range of motion, bed mobility and transfers, ambulation) received in the ICU. Sample size calculation We will recruit 60 patients for this pilot RCT. Our sample size calculation is based on identifying a 0.25 standardised effect size for the full RCT for the PFIT-s at hospital discharge. Assuming a baseline SD of 3.06 points at ICU awakening, we hypothesise that 0.75 points in the final PFIT-s score at hospital discharge is clinically important for the main trial.

Using a CI approach for continuous outcomes, we require 504 participants with outcomes at hospital discharge to detect a difference in the main trial (α=0.05). For the pilot RCT, we will recruit 9% of the sample size for the planned main trial to have an 80% power to detect such a difference. Thus, we need to recruit, randomise and analyse 46 patients (23 per group) to produce a one-sided 80% confidence limit, which would exclude a 0.75 difference on the PFIT if the point estimate from the pilot study were 0.

Assuming 25% in-hospital mortality, we plan to include 60 patients in the pilot RCT. Statistical analysis For all feasibility analyses, we will include all patients randomised, regardless of protocol adherence. We will conduct a subgroup analysis of patients ≥65 years old. Since elderly patients are under-represented in critical care trials, and no studies have specifically studied early cycling in the elderly critically ill, subgroup analysis of these patients for our four primary objectives will help to identify barriers and facilitators to conducting the research protocol in this population.

We will have no formal interim analysis in this pilot trial. We will use data from the CYCLE pilot RCT in the full CYCLE RCT and will consider public access to data and statistical code after the full RCT. Outlines the variables, hypotheses, outcome measures and analytic methods for our four feasibility outcome measures. Trial management The Methods Centre, coordinated by St Joseph's Healthcare and McMaster University, will oversee all contracts, research ethics board preparation, site initiation and training, screening log and data submission, data quality assurance, study close-out, and finances at each site. It will develop and prepare all study materials (eg, standard operation procedures, operations manuals, data collection forms) for participating sites, be the point contact for study questions, and will communicate important protocol amendments electronically to relevant parties.

To protect confidentiality, all data will be anonymised and entered into iDataFax, a password-protected encrypted server that runs on Red Hat Enterprise Linux. All PIs will have access to the clean data set and their local data after the full CYCLE RCT. Ethics and dissemination We will disseminate study results regardless of the magnitude or direction of effect. We will disseminate results to key stakeholders (eg, critical care clinicians, critical care triallists, research funders and the public) through conference presentations, peer-review journal publications, trial registry (clinicaltrials.gov) and the CYCLE trial website (). We will submit trial progress summaries to our sponsors as required. We will not use professional writers and will follow the International Committee of Medical Journal Editors for authorship.

Limitations and strengths of the CYCLE multicentre pilot RCT The CYCLE pilot RCT is designed as a feasibility study, and is therefore not powered to determine treatment effectiveness. In-bed cycle ergometry only targets the lower extremities, whereas the upper extremities and torso also weaken with bed rest. Implementing this cycling protocol as part of their normal role will add to the workload of participating physiotherapists; however, we expect that efficiency with the cycling protocol will improve over time in participating centres, as recorded in our pilot study.

Cycling is not necessarily a functionally oriented therapy; however, once patients can march on the spot, therapists will transition from cycling to help patients focus on advancing other mobility activities. Moreover, cycling allows both passive and active activity, which is easily adaptable to a patient's current physical status. Our pilot trial is modest in size but is a foundational step in this research programme. This study will engage the largest number of ICUs to date in the field of critical care rehabilitation.

Numerous strengths of this proposed research include the innovative, portable and publically familiar intervention of cycling. In-bed cycling can occur while patients are deeply sedated, unconscious or are minimally interactive. Our intervention targets the leg muscles, which account for 75% of total skeletal muscle mass, and are most vulnerable to loss of muscle size and strength during bed rest. Unlike ambulation during MV, which can require up to four clinicians, cycling only requires the assistance of one clinician. Our pilot data support the safety and feasibility of early cycling in critically ill patients receiving MV and we are engaging front-line PTs to provide the cycling intervention as part of normal care, in anticipation of future knowledge translation efforts.

To reduce detection bias, we will conduct blinded functional outcome assessments at hospital discharge. We will collect key feasibility data to inform a future larger RCT.

Results from the CYCLE pilot RCT will inform the future large-scale multicentre CYCLE RCT. Consistent with the four primary objectives of our pilot RCT, we will identify barriers and facilitators to accrual, including occasions to revise inclusion and exclusion criteria, and improve the informed consent process, if needed. We will systematically collect protocol violations to identify opportunities to optimise and streamline the delivery of in-bed cycling in other centres by seeking direct feedback from the front-line physiotherapists at each site. We will assess our ability to conduct outcome measures at ICU awakening, ICU discharge and hospital discharge, and blinded outcome measures at hospital discharge. Finally, results from our pilot RCT will document the nature and frequency of routine PT interventions in multiple centres in the new era of early mobility activities in critically ill patients. We anticipate the primary outcome for the full CYCLE RCT will be the PFIT-s, powered to detect a difference in patients' function at hospital discharge.

Thus, our ability to successfully measure outcomes with minimal losses to follow-up is critical. We will collate and synthesise strategies from outcome assessors to maximise our outcome measures.

Observed hospital mortality and loss to follow-up data will inform the number of patients we will need to recruit for the full CYCLE RCT to achieve our target sample size at hospital discharge. By 2026, the number of patients aged >60 years requiring MV is expected to increase by 105%. This presents an urgent need to proactively address ICU rehabilitation needs, since more of these survivors will be at risk for post-ICU disability. If effective, early in-bed leg cycling could decrease disability and may represent a cost-effective healthcare intervention. Twitter: Follow Michelle Kho at Collaborators: Canadian Critical Cae Trials Group. Contributors: MEK was involved in study conception and manuscript draft, and MEK, FC, MSH, KKYK, JR, AJES, JRP, J-ET and DJC contributed to design.

MEK, DJC, KKYK and MSH provided expertise in clinical trial design. MEK, DJC, JR, JRP, J-ET, TK, MSH, AJES and MM are grant holders. This study is part of a research programme supported by the Canadian Critical Care Trials group.

All authors contributed to refinement of the study protocol and approved the final manuscript. Funding: This work is supported by grants from Technology Evaluation in the Elderly Network Catalyst (CAT2014-05), Canadian Respiratory Research Network Emerging Research Leaders Initiative, Ontario Thoracic Society Grant-in-Aid, and Canadian Institutes of Health Research Transitional Operating Grant (Award #142327), Canada Foundation for Innovation, Ontario Ministry of Research and Innovation. MEK and DJC are each funded by a Canada Research Chair. Restorative Therapies (Baltimore, Maryland, USA) provided two RT-300 supine cycle ergometers for Toronto General Hospital and London Health Sciences sites for this research. Competing interests: MEK received an equipment loan of two RT300 supine cycles from Restorative Therapies, Baltimore, Maryland, USA, for this study.

MSH and Ian Ball are each site investigator at centres where MEK received the equipment loan from Restorative Therapies. Disclaimer: The funding sources and equipment manufacturer had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data, or decision to submit results. Ethics approval: The following Research Ethics Boards (REBs) approved this study: Hamilton Integrated REB for St Joseph's Healthcare, Juravinski ICU, and Hamilton General ICU (14-531); Toronto General Hospital (15-9282); London Health Sciences (107202); St.

Michael's Hospital (15-334); Ottawa General (20150732-01H). Provenance and peer review: Not commissioned; peer reviewed for ethical and funding approval prior to submission.

I promise I read the manual a couple times, Youtubed and Googled this, but for the life of me I can't figure how to properly start and stop recording my routes for the eTrex 30x. I've had an Edge 305 and in the past and my Edge 500 is crapping out so I decided to upgrade to the eTrex 30x mainly for the ability to record and also load big routes like Tour Divide. With my 305 and 500, I simply start the time and stop it when I'm done, then reset it and everything is saved and simply upload to Connect once I get home. Without a simple start/stop/ and reset button I must be doing something wrong because it just seems like the timer starts automatically after I go to trip computer and start moving. When I end my ride, I reset all all the data and save the tracks. Then I upload it to Connect but the stats don't match. For instance, I did I uploaded an hour ride I did and when I uploaded it, it showed that I had 42 hours on it.

Checked all my times and elevation, and everything was completely flat except for the first 41 hours but last had all the stats that I did for that hour ride. I'm not tech savvy by any means and to be honest, the features on the eTrex is more than I need but it's significantly cheaper than the edge 520 and 820 on Amazon. Another reason I didn't get another Edge is because it doesn't have enough internal storage and no ability to expand the storage to be able to handle long rides such as Tour Divide or Colorado trail. I simply just want to be able to record and end my rides and save it when I want. Pleeeeaaaassseee help!! It starts recording as soon as you turn it on, and stops when you turn it off.

Therefore, I turn mine on at the start of the ride, do a RESET of Trip Data (so everything is zero), then start riding. At the end of the ride I turn it off. Then when I upload the ride to 'Strava/Garmin' I load the current.gpx file. When away for a longer period, each day I do as follows: I turn mine on at the start of the ride, do a RESET of Trip Data (so everything is zero), then start riding.

At the end of the ride, I save it (usually called 'Day 1' etc), then turn it off. Do this each day and in the end at home you load the saved files into 'Strava/Garmin'. I would suspect when you do a save mid ride, you can upload the saved data (using the name you saved as), or the complete data using the current.gpx file. But I also never read the manual, so there may be an easier way.

Either the manual doesn't do a good job of explaining or I'm just not good at following instructions. I'd like to think it's not the latter No, you're correct that the manual doesn't do a good job of explaining it.

Basically two things to remember: It starts recording as soon as you turn it on and it connects to satellites. You have to clear the tracklog manually if you want to make sure your current ride doesn't connect with previous ones (on fitness models, this action is accomplished at the same time you save your ride). I will assume that the recording interval you're using is NOT 1Hz. This is another major difference between handhelds and fitness receivers (one that I REALLY wish Garmin would change). Loco Mania Cd Key Serial Keygen Patch.

Handhelds have a fixed tracklog memory limit of 10,000 points. For fitness models, it's based on time. On a handheld, if you're using 1Hz recording frequency, you'll fill that tracklog in a couple of hours. Most handhelds have choices for ways to handle this - either to overwrite the oldest points, or to auto-archive the oldest points (my Oregon 450 does it in 2,000 point blocks). This means that uploading a complete track can be a bit of an ordeal because Garmin Express won't auto-upload the archived stuff, and your active tracklog will only have part of your ride. So you have to splice them together and upload manually if you want your ride to show up as one actual ride, rather than being split up. There are a few key differences between the way handheld GPSes work and the way fitness GPSes work.

Frankly, the memory one is why I stopped using my Oregon 450 on the bike. Thanks for the great info guys! I don't know why they can't just make recording simple like the fitness models. --Harold, I have it set up to record at 5 sec intervals and set to archive when full. I have mini sd cards I can use also for storage in need be and that's one of the reasons I got this unit. I'm doing the Tour Divide Race in June and would hate to not be able to record the whole thing.

From my understanding based on what you said, once I reach 10,000 points, it'll auto archive and continue recording? So basically it'll record all 2,700 miles of the Tour Divide but it'll break it up into splits and then I can combine the splits to make it one long ride? Thanks for the great info guys!

I don't know why they can't just make recording simple like the fitness models. --Harold, I have it set up to record at 5 sec intervals and set to archive when full. I have mini sd cards I can use also for storage in need be and that's one of the reasons I got this unit.

I'm doing the Tour Divide Race in June and would hate to not be able to record the whole thing. From my understanding based on what you said, once I reach 10,000 points, it'll auto archive and continue recording? So basically it'll record all 2,700 miles of the Tour Divide but it'll break it up into splits and then I can combine the splits to make it one long ride?Well, the hiking model arrangement did come first. The fitness model setup came later. I think the grumpy hikers (geocachers) would get grumpy if garmin changed the ui too much. I think in part it is a way for garmin to distinguish models. Just diff software.

Yeah, if you have it set to auto archive, your whole ride will be there. Make sure you have plenty of memory. I don't think you can set the save location of archive data so it will all go onto the onboard memory. Use those memory cards for as much as you can (maps, esp). Sent from my SM-G900V using Tapatalk. Heh, I just got one of these to replace my old 20 and the change was fairly intuitive. To make it more user friendly this is how I set it up: Go into the main setup menu and click on tracks and set the track log to 'record, show on map' Go back to the main setup menu and scroll down to the page sequence option, click it and then click 'add page' I added from stock (in this order): Main Menu (was already there) Track Manager Map Trip Computer Satellite Leave the setup menu and the back button will now cycle through those options.

When powering on and before a ride, press the back button until you see a menu with 'Current track' highlighted. Click this and push up once on the joystick and click on 'Clear Current Track' and subsiquently 'Yes' You're now ready to ride with a clear tracklog. To save a track is pretty self explanatory. Go back to where you clicked on current track and select save track. After saving it'll ask if you want to clear the trip log (I don't bother until I ride again) Hopefully that helps some; I never was good at explaining things! The gpx files just became available for 2017 Tour Divide and I downloaded it onto my unit. This is my first time downloading anything gpx files and just want to make sure I have it correct before I get to the race and get lost.

I see the the line for whole route when I go into track manager and select the route, but am I supposed to see dots or x's on the map for waypoints? When the race starts, do I just simply follow the lines? Thanks all.If the file type in the.gpx file is set to 'track', it will display as a line. If it was set to 'waypoints' then you'd see a series of points. If 'route' then waypoints with a line connecting the dots. The structure of the tags in the file will differ somewhat between the three, also, so there's a little more involved in converting between the three.

You should just be able to follow the line, but you may find complications there depending on how the route was sent to you. I've never actually seen files from an event like the tour divide, but I know from experience that the handhelds can only handle saved.gpx files with a max of 10,000 points. And if you try to load a file with more, then the GPS will automatically break up that file into manageable pieces, and it will give them names that make it next to impossible for you as the user to figure out which one is first and which one comes next. Edges and Forerunners can handle bigger files (limited by the number of hours), but something like the tour divide is SO BIG that it would need a lot of massaging to fit on an Edge, too.

I would hope that a professional event like the tour divide would split the whole route into manageable pieces that will fit onto the various devices people like to use, but I don't know for sure. As for following it, on your handheld, you can tell it to navigate a saved track or route and it will give you notifications (those notifications will differ depending on whether it's a track or a route) to help you go where you're supposed to. Or you can 'visually' just stay on the line, which is what I often do on the mtb. Here's the link for the track: Maybe you know how the.gpx files are set.

I downloaded the file that have only 10,000 points. When viewing on my unit, it only shows a line so I guess that means it's set to 'track'. Is there a way I can change it to 'waypoints' or 'route'? As far as following it on my etrex 30x, I just go to track manager and select the file for the tour, load the map and just start riding and just follow the lines?

Simple as that, right?You can convert a track to either of those types. A series of waypoints would be a royal cluster on your device, so don't do that. A route MIGHT be useful, and you can convert a track to a route. That will require loading the file into a program that does such a thing.

By necessity, it will strip a LOT of points out of the files, though, and will point you to the next one 'as the crow flies' so the directions may not be entirely accurate on singletrack. It's better when you're on straighter roads. If you google 'convert.gpx track to route' you can find some instructions on it. Some programs/sites that will do this include GPS Babel (standalone program) and gpsies (website).

Better to try it before you commit to using it that way. Thats how I do it would be good if I could work out how to make it 'beep' and give a direction when I near an 'intersection' though, but Im lazy That's what a 'route' will do. Also a Course on the fitness models. I'd really like 'course' functionality to come to handhelds. Courses, especially with custom turn notifications like you can insert in there using a site like RideWithGPS, are really nice and can be useful on singletrack. I'd not use it except on roads. I know the tour divide uses lots of gravel roads, so it might be useful.

But I'd be checking things over long and hard before using a route for something. It will certainly be easier from a device usage standpoint to just follow the tracks you have already.

No data massaging needed if they're already in segments of 10,000 points or fewer. Stripping down a track to convert it to a usable route could be particularly time consuming, as you'll have to be careful about the placement of each route point to make sure it's placed right in order to give you the notification you want.

Don't place it right, and it probably won't give the right notification.