I think a big roadblock for me in Ultrakill is that I would need a mouse with three side buttons ? Maybe. To put all the shit which is keybound to my left hand area.
Because yeah, I can begrudgingly, as an old man with tremors, use slide or dash on 'left shift' and 'left ctrl'. Both is pushing in a twitchy game, but...

When you had a punch button on 'F' and a change weapon style on 'E', MY LEFT HAND HAS A PANIC ATTACK.