The video game industry is massive, with an estimated value between $160 billion and 180 billion. Thankfully, developers are finally working to make games more accessible, and new devices like Microsoft’s Xbox Adaptive Controller are allowing gamers with any level of function to play.

But before Microsoft and other companies focused on adaptive gaming, there was the QuadStick. Since 2014, the QuadStick has been the premier mouth-operated controller. The QuadStick FPS is one of three hands-free gaming devices in the QuadStick family. The controller works with all types of games but got its name from, and was designed especially for, first-person shooters. The QuadStick FPS is operated entirely by the user’s mouth and is appropriate for those with limited or no arm and hand function. As a C5-6 quadriplegic, I am not the target audience for a hands-free device, but I wanted to try the unit out to show what is possible for other gamers.

The QuadStick FPS is made up of a joystick, four sip-and-puff sensors, and a lip button. Each component can be customized to execute a different function on the computer or gaming console being used. For example, the joystick can be programmed to work as a mouse on a computer or as a joystick or D-pad on a video game controller. Similarly, the sip-and-puff sensors and lip button can be assigned so that a puff on the middle sensor works as the B button, or a sip on the right sensor engages the right trigger. While playing, the user can switch between modes to use the different joysticks and D-pad on the fly.

The QuadStick FPS can be attached to a mounting kit that can be connected to a wheelchair, desk, or bedside table. My demo unit came with the Flexible Mounting Arm Kit that is available on QuadStick.com for $105. I attached the kit to a bedside table and was able to move the table and adjust the height so that I could use the QuadStick FPS without a problem. Other mounting kits are available from QuadStick.com, or a customized mounting kit can be built with components found online.

During my time with the QuadStick FPS, I tested it with the Nintendo Switch and Xbox Series X. The controller works out of the box with the Switch, PS3 and PS4, Mac and Windows computers, Android, and iOS 13+, but needs an adapter to work with newer systems like the Series X and PS5. I used the Brook Super Converter for testing with the Series X.

The QuadStick FPS works very well and I did not encounter any significant glitches while using it, but there is a learning curve. The sensors always registered my sips and puffs, but it took a while for me to learn the difference between a soft sip and a hard sip, and a soft puff and a hard puff. As any gamer would know, pressing the wrong button can be the difference between clearing a level and dying, so it is important to be accurate when you are playing. None of this was the fault of the controller or the software, but don’t expect to be a gaming god after a few sips and puffs.

The most difficult aspect of using the QuadStick FPS for me was remembering how to actually play a game with it. As one can imagine, it takes some creativity to put all the functions of a standard game controller into a device with one joystick, four sip-and-puff sensors, and a lip button. For example, the Xbox Series X controller has 11 buttons, two joysticks, and one D-pad. The fact that the creators of the QuadStick FPS can make this work is quite remarkable. However, memorizing how to make the buttons work was difficult, and I never got the hang of it completely. Fortunately, there are cheat sheets available that lay out the various commands for individual buttons. There were many times when I would have to pause a game just so I could look at the cheat sheet and plan my next move. As with anything new, it takes time and practice to learn. With more practice I am sure I would have become more proficient.

One of the best features of the QuadStick FPS made learning the sip-and-puff commands more difficult, but at the same time made games easier to play. The QuadStick Management Program is a Windows app that allows the user to customize their controller. Joystick sensitivity and the sip and puff threshold can be adjusted, firmware can be updated, and custom game profiles can be uploaded. The QuadStick FPS has a flash drive that can store 10 custom game profiles.

While I was testing the QuadStick FPS, I was able to download profiles for Breath of the Wild for the Nintendo Switch, as well as Assassin’s Creed: Valhalla and Cyberpunk 2077 for the Xbox Series X. These profiles, and many others, can be found and downloaded from the QuadStick forums. Once downloaded, the user can customize the profiles further, or load them directly to the QuadStick FPS. Custom profiles can also be built completely from scratch to suit the specific needs required of individual games. Learning different commands for every game is difficult, but it is worth it as it makes the games easier and more fun to play.

The QuadStick FPS is an excellent hands-free gaming controller for those with limited or no arm and hand function. It works with all of the major gaming consoles, Windows and Mac computers, and most current Android and iOS devices. It does take a lot of practice to get used to playing with the QuadStick FPS, but it is worth the effort as it opens a world of opportunities for long-time gamers and those looking to get into the hobby. The QuadStick FPS is available for $549.99 at QuadStick.com.