My right hand holds the spinner knob seen on the steering wheel at far right of picture. My left hand holds the new handle sticking out below the turn signal. If I push forward, it activates the brake pedal. If I rotate the handle towards the floor, the accelerator pedal is activated. The gear control for this car is on the center console. Driving with hand controls feels completely normal. It has been shown that your reaction time is faster with hand controls than by using your feet. If an able bodied person wants to, they can drive the car as if there aren't any extra controls (The spinner knob can be easily removed)