Reassigning Voiceover keystrokes

[E.J. Zufelt]

Good evening,

Is there a way to reassign a voiceover / mac keystroke?  For example,  
I'd like to reassign the next paragraph command in Voiceover to VO +  
Control + down arrow.

Also, has anyone realized how compllcated Voiceover would be for an  
individual with manual dexterity problems, particularly if they only  
had use of one hand)?

Thanks,
Everett