i am diabetic and sometimes have problems with my feet. i ride a recumbent trike and found my feet slipping off the pedals so i bought bicycle shoes with clips and new pedals to go with them, now i ride perfect. i also wear 2 prostetic hands and bar end shifters work best for me. i rotate the brake lever backwards and the brakes work fine. i will only use linkage steering or indirect steering as it steers like power steering, i don't like direct steering. i also own 2 adult tricycles, they ride nice however you can not go fast and make a sharp turn as the trike will tip over easily. they ride nicely if you ride slowly like on the street in front of your house. on the adult trike i would recommend 3 speed minimum, single speed you cant ride up steep hills to good. i own a trek pure aluminum single speed adult tricycle, sun 3 speed adult tricycle, scorpion fs recumbent trike, terratrike tour recumbent trike, sidewinder pro cruiser recumbent trike. for me i know what works best.