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I'm playing it on an index with vive wands, playing in a medium-small room. Without my cane I can only stand for about 5-10 minutes max. I can't crouch or bend, period. In theory I could try the one handed mode and use my cane, but I've been playing seated with two hands.
One of the reasons I was excited for this game is because I knew Valve was a company that wouldn't release a VR game without taking accessibility seriously. Alyx isn't perfect, but it's definitely the most accessible game I've played to date.
Under the accessibility menu there are three options. Toggling one handed mode, height adjustment bindings, and an option to reduce flickering. It's the height adjustment that's big for me and other seated players.
You can set a button on your controller to move your head to a crouched height, a standing height, or a hybrid where you hold it to stand and press it to crouch. This is what I've been using, since seated height is higher than crouching.
It's been working great so far. The biggest thing I miss is a fine position adjust, since it's hard to teleport move to precisely where you want to stand (or even to know where precisely you want to stand), so I often open cabinets into my face which is uncomfortable
The other thing that makes this game so much more accessible is the mechanics of the gravity glove. When you have a clear path to an item, you can point at it and have it fly into your hand.
This means that even though I have limited movement in a chair, I can still easily pick anything up, since I don't have to get super close to it. The radius for being able to interact with things is pretty generous too.
That said, I do find myself needing to lean uncomfortably far forward more often than I should (e.g. I cannot comfortably open the health stations, hopefully a patch can solve this in the future). Doors are also difficult for me.
Finally, even though the game can be played seated (and is advertised as such), there's absolutely no guidance on how to do this properly. You're just sorta left to flip through all the options and try to figure it out for yourself.
Overall though I found the game to be pretty good from an accessibility point of view, and hopefully this is a sign that I will actually be able to start getting some more value out of my VR kit. 7/10 could be better, but definitely playable.
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