Over the years, we have had the privilege of helping many players with hemiparesis. The situations are slightly different for every individual, but we have a few general recommendations of controllers that could help depending on your situation.
Research each controller and review the associated YouTube videos to ensure you are making the right decision for your gaming needs.
TrackIR
TrackIR is a head tracking input device designed to use with gaming and simulation PC titles. Players use their head to play most games, ranging from Indie to AAA titles. While it can be used as a standalone controller, it is also compatible to use with other controllers and input devices (i.e. a mouse or keyboard).
Without getting too much into the details, the powerful infrared camera tracks the position and orientation of your head, and then sends that data to any of the 100+ TrackIR Enhanced games and simulations.
Along with the TrackIR, there is also the TrackClip, which is included with every TrackIR 5 purchase. The TrackClip attaches to the brim of a hat or visor and has three retro-reflective markers that direct infrared light back to the camera. The TrackClip Pro, which attaches to most PC headsets, comes with active LED markers and is useful when you need to track from further away.
TrackIR Explained: https://www.youtube.com/watch?v=_AO0F5sLdVM
TrackIR can also be used as a keyboard replacement. With a software called TrackMapper, TrackIR can be programmed to press up to four keys in any combination when you move your head as little as half an inch in any direction.
More commonly, we often used TrackIR with the TrackMapper to get the full usability out of it. The TrackMapper allows the TrackIR to set hotkey replacements (up to four to be precise). It also allows you to use it with any game, whereas the TrackIR in its standalone form does not.
Play Tilted
Tilted is a wearable controller that allows you to map up to 8 gaming commands using short-head movements. Don’t be fooled though! This is not a head tracking device, like the TrackIR or Tobii. Rather, it focuses on your direct movement, which allows for a much faster response time when you’re in the game.
You decide how much head movement is needed for each command, using their sensitivity and calibration sliders in their software. You can place the controller on the brim of your hat or headset, or really any other body part that you think would be the best fit for you! This controller can be used with any game, because it communicates with your PC as any standard keyboard would.
Take a look at the Play Tilted website for more information, including videos of the controller in action.
One-Handed Controller
As the name sounds, one handed controllers are controllers that allow players with one hand to access all the needed buttons and joysticks that is presented on a standard controller. But don’t be fooled by the title; these controllers are instrumental to many players who are not missing a limb. 
We highly recommend checking out EvilController’s library of accessible controllers. These are the most popular with our community, and for good reason! They are durable, and have optionability for including additional joysticks, ambidextrous options, usage across different consoles, and more!
They also included informational YouTube videos about their controllers. For example, if you are interested in a one handed PS4 controller, you and watch their YouTube video review and how-to.
XAC with Switches
The Xbox Adaptive Controller (XAC) is a powerful controller that has shown monumental potential for players in our community. Utilizing the 3.5mm ports on the back, players can plug in their favorite switches into the associated buttons, thus allowing them to play their favorite games their way.
Furthermore, the XAC has two USB ports, where players can then plug in adaptive joysticks that best allows them to game.
To use the XAC to its full potential, it’s important to invest in switches. The XAC essentially acts as a master hub; while this is critical to play, the switches you use is what truly opens the door to gaming.
There are tons of switches (a.k.a. buttons that can be placed just about anywhere) on the market. You can find switches for a variety of situations including, light touch, rigid, and even ones called “twitch switches,” which can be placed on a muscle such as your calf or eyebrows. You’ll want to do some research to ensure you are buying ones that will work best for you.
AbleGamers recently collaborated with Logitech to release their Adaptive Gaming Kit at an economical price of $99. We highly recommend checking this option first. The kit comes with:
Light Touch Buttons:
- Sensitive, light-pressure buttons with a 12 mm height that can be activated with low force.
Variable Buttons:
- Pressure-sensitive triggers can function like gas pedals, ideal for racing games or other applications. Force tune them for optimum control and comfort.
Small Buttons:
- Approximately 1.4” buttons, built with mechanical switches, offer durable and consistent actuation. Low height allows for easy and quick presses.
Large Buttons:
- Approximately 2.5” buttons built with mechanical switches are reinforced with stabilizer bars for consistent actuation across the full surface.
If you need something different, like a mouth switch or sip and puff switch, EnableMart has a variety of switches that range in size, touch requirements, and how they’re used. Make sure that for any switches you purchase uses a 3.5mm jack. Unfortunately, many of these switches are very pricey, but it’s a great place to start. Xbox also has a forum on what external devices work with the XAC.
Otherwise, check out the complete resource guide from Xbox on the XAC. They provide all additional details and associated videos to help in your decision making!
Axis Controller
The Axis Pro Controller was developed through years of collective gaming experience from both able-bodied and disabled players. Engineered and then perfected through countless prototypes and testing, the Axis Pro is built for all levels of gaming enthusiasts. Featuring genuine Sanwa™ buttons, two premium analog joysticks and a precision 8-way digital stick, the Axis Pro offers peak performance and reliability.
The Axis Pro offers several ergonomic layouts, making it the gamer’s dream stick for console and PC gaming.