To refresh, Zanardi lost both of his legs and three-quarters of his blood in a crash in 2001 at a race in Germany. Lucky to be alive, he returned to racing full-time in 2004 and racked up four wins at the FIA World Touring Car championship to add to his two CART championship trophies. He also is a four-time handcycling Paralympics gold medalist, so yeah, this dude is pretty badass.
Zanardi says he tends to use his left hand to pull on a lever mounted just behind the steering wheel that serves as his accelerator because "the other one is busy doing other stuff." Another pedal mounted to the wheel serves as an upshifter, while a trigged mounted to the brake lever allows him to downshift with his right hand. The setup leaves the traditional foot pedal box untouched, which means the car can also be operated by his fellow drivers. "It's a very compatible, let's say, setup, mechanisms also for endurance racing where I have to share the car with able-bodied drivers," he says. And dig his explanation about applying nearly 500 pounds of force to the brake lever at a pit stop.
Above is another recent video made by BMW Motorsports showing how it all works on the Daytona Speedway.