There are several parts to this; some of them are shared with voice input to emacs.
For years now, I've been using a triple pedal setup with emacs -- at first the one made by Bilbo.com, and more recently the more robust one sold by Kinesis. It has a large central pedal and a smaller one to each side, and comes pre-set to do Ctrl, Shift and Alt.
I find it makes a big difference to ease of use.
For a few months now, I've been trying to take more of the load off my hands (I have moderate RSI, which started around when the Ctrl key moved from its old place -- where Caps Lock is on most modern keyboards) and now have two triple pedals, daisychained together and mounted on a wooden board with notches cut to locate my heels unambiguously relative to the pedals.
The LH (LF?) cluster is set to Ctrl, Shift, Alt, and the right cluster to three keys I wasn't using much (on the keypad -- I have had to experiment on different machines to find which ones can be read properly with all the modifiers) and programmed those keys accordingly.
Broadly speaking, the pedals work like this:
This does "dimensional navigation": there is a "current dimension", indicated by cursor color, and the big right pedal is "next" or "forward" in that dimension; shift-next is "previous", ctrl-next and ctrl-shift-next select next and previous dimensions, and alt-next and alt-shift-next move extend the selection by units of the current dimension. There are several series of dimensions available, such as cartesian (up, down; left, right; etc); structural (in/out/over sexps) and by meaning for text (words, phrases, sentences, paragraphs).
The right-edge pedal on the right is "menu/select", bringing up a modified text-menu for the main system menu, which can then be navigated up and down using next/previous and selected using menu/select again.
Shift-menu brings up a position-related menu (a bit like the second button of a mouse often does).
The left pedal of the right set does the corresponding moves in the dimension above the one used by the big central pedal. For example, if the central pedal is moving by words, the left one will be moving by phrases, and if the central one is moving by sentences, the left one will be moving by paragraphs.
And a lot else besides -- things I use too much to go through menus for them get pedal combinations of their own.
You can get the emacs pedal software as part of Versatile cursors from SourceForge.
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