Here is the other thread with a little more information.

Hello from Germany - I donīt have arms but still ride my bike.

So [MENTION=509434]Armlesscyclist[/MENTION] uses toe shoes... as if they were made just for her!!!

And, shifting can be done with an appropriately mounted shifter.

I would still choose a bike with coaster brakes. Which would be easier with the pivoting front wheel like the trihauler than the tadpole like in the Jessica video above.

A backup brake would still be handy if the chain gets flipped off or broken.

The tri-hauler does sit fairly high, and gets stability through being wide, and carrying a load. It probably could be lowered slightly, but there may be limits with that steering.

They are made to go one direction, forward, although one could do something like the S3X internal gear "fixed" 3-speed, but one would have to be careful with shifting and not losing the pedals.