I did TONS of research and recommended this product to a man I know who recently lost use of his arms and hands. Not being able to change the TV channel himself was a source of much frustration.
When the remote first arrived, both he and his wife tried to get it to work for about an hour and couldn't get it to do a thing. Their friend stopped over and was able to pick it up and it worked right away for him. For whatever reason, his voice primed the remote and from then on it worked....mostly.
Another issue they had was the sensitivity of the remote when it was turned on. Apparently, one night they had company and every time someone said a word begining with "d" the TV went down one channel. Once you adjust the sensitivity, it doesn't do this.
Now, this remote can be programed so you can just say "ABC" and it will turn on that channel for you. However, it does take quite a bit of work to understand and follow the directions to program the remote so it will do this for you (this is why I gave functions a "3"). Really it has soooo many things you can make it do it is unbelievable.
Also, this remote will not work for you if you don't have good lung compacity. You need to be able to talk in a clear voice. But it would be great for a quadriplegic or stroke victim.
Here's the website if you are interested: