Hands free!
Just kidding. Granted, I do have a case with stand for my PW4 so when I'm eating for example, I don't hold it, just tap or swipe on the screen to turn pages.
Normally, I hold my PW with one hand and use my thumb to turn pages. I've modified KOReader tap zones so a tap on almost the entire display area advances to next page. I just use swipe for previous page.