0- Install SKSE
1- Install Locational Damage (http://www.nexusmods.com/skyrim/mods/12615/?)
2- Install PapyrusUtil (http://www.nexusmods.com/skyrim/mods/58705/?)
3- Install LDPerformancePatch

NOTE: LDPerformancePatch includes an SKSE plugin. This plugin may have to be manually placed in your Skyrim\Data\skse\plugins directory
if you are not using Mod Organizer. Mod Organizer is recommended as the safest and most transparent way to install this patch.

NOTE 2: As of 8/2016, this is a BETA; install with caution, back up your save.