In whatever game you are using, if you are able to set more than one command for an action like "gear up" such as Joystick Button 3 and also Keyboard G, it would be the most efficient way to integrate VoiceAttack for action commands in a game. Most games and simulators allow for more than one input assignment for an in-game action. You should try to do this if at all possible because if you find the PDF manual difficult to read, you might find the process for configuring a virtual joystick equally frustrating.
Pro tip: use CTRL+F to Find a keyword in the manual you are looking for more quickly.