Hola MuddyTrails,
I don't recall seeing anyone post about handcycles in this forum (my apologies if someone did). From a quick look at handcycles, I see that many use Shimano components, so you can find 11-32 cassettes. Perhaps posting in a disability related forum might give you more of the insights you seek, plus issues related to fit. I would suspect that when it comes to road/off-road, you will face some of the same issues as choosing between a road bike and a mountain bike.
Saludos desde Chicago.